Life Line Chiropractic

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

SC2755 Issued in SC

Legal business name

LIFE LINE CHIROPRACTIC

Practice address

Life Line Chiropractic
1151 Robert Grissom Pkwy
Myrtle Beach, SC 29577

Phone

(843) 839-5588

Fax

(843) 839-5591

NPI assigned

Dec 13, 2006

Last updated

May 11, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tammy L Costello, D.C.NPI 1558456202

Title

Owner

Phone

(843) 839-5588

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tammy Lynne Costello, DC

  • Sports Physician Chiropractor
  • Myrtle Beach, SC
  • NPI 1558456202
  Authorized official Same address or phone
• Jon Clark Holt, D.C.

  • Chiropractor
  • Myrtle Beach, SC
  • NPI 1083751622
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242000000000",
    "number": "1649331380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LIFE LINE CHIROPRACTIC",
            "address_2": "1151 ROBERT GRISSOM PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29577",
            "telephone_number": "843-839-5588",
            "fax_number": "843-839-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LIFE LINE CHIROPRACTIC",
            "address_2": "1151 ROBERT GRISSOM PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29577",
            "telephone_number": "843-839-5588",
            "fax_number": "843-839-5591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE LINE CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2009-05-11",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-839-5588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "SC",
            "license": "SC2755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lewin
• Isabel Lewis, MD
• Kellie McDougall Lewis, L.I.S.W-CP, CAC-AD
• Liberty Healthcare Group, LLC (Liberty Home Care and Hospice)
• Liberty Medical Specialties, Inc.
• Life's Best at Home Care LLC
• Lifealoud (Beach Audiology)
• Lifebridge Intergrated Care Services, LLC
• Lifecare Counseling LLC (LifeCare Counseling)
• Lincare Inc

• Sports Physician Chiropractor in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Sports Physician Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2009; 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.