Palmetto Chiropractic Neck and Back Center of the Pee Dee, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2843 Issued in SC

Legal business name

PALMETTO CHIROPRACTIC NECK AND BACK CENTER OF THE PEE DEE, LLC

Practice address

2147 Hoffmeyer Rd
Suite a
Florence, SC 29501-4015

Phone

(843) 662-8000

Fax

(843) 664-0994

NPI assigned

Nov 14, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Bryan C Wenner, D.C.

Title

Owner

Phone

(843) 662-8000

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508938770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2147 HOFFMEYER RD",
            "address_2": "SUITE A",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014015",
            "telephone_number": "843-662-8000",
            "fax_number": "843-664-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2147 HOFFMEYER RD",
            "address_2": "SUITE A",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014015",
            "telephone_number": "843-662-8000",
            "fax_number": "843-664-0994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO CHIROPRACTIC NECK AND BACK CENTER OF THE PEE DEE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WENNER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-662-8000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. BRYAN WENNER",
            "identifier": "1639162605",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH2843",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Florence, SC
• Providers in Florence, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.