Glaza Chiropractic Center, Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1193 Issued in SC

Legal business name

GLAZA CHIROPRACTIC CENTER, INC

Practice address

548 Nautical Dr
Suite 204
Lake Wylie, SC 29710-0016

Phone

(803) 831-2345

Fax

(803) 831-2007

NPI assigned

Sep 15, 2006

Last updated

Feb 24, 2012By 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. Al Gerard Glaza, DCNPI 1306805916

Title

Chiropractor

Phone

(803) 831-2345

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

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.

• Al Glaza

  • Chiropractor
  • Lake Wylie, SC
  • NPI 1306805916
  Medicare reassignment NPD Authorized official
• Connor Owen Glaza, DC

  • Chiropractor
  • Lake Wylie, SC
  • NPI 1205778339
  Medicare reassignment NPD

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330041600000",
    "number": "1679679971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "548 NAUTICAL DR",
            "address_2": "SUITE 204",
            "city": "LAKE WYLIE",
            "state": "SC",
            "postal_code": "297100016",
            "telephone_number": "803-831-2345",
            "fax_number": "803-831-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "548 NAUTICAL DR",
            "address_2": "SUITE 204",
            "city": "LAKE WYLIE",
            "state": "SC",
            "postal_code": "297100016",
            "telephone_number": "803-831-2345",
            "fax_number": "803-831-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLAZA CHIROPRACTIC CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2012-02-24",
        "status": "A",
        "authorized_official_last_name": "GLAZA",
        "authorized_official_first_name": "AL",
        "authorized_official_middle_name": "GERARD",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "803-831-2345",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "1193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GCH293",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Leigh Fronczkiewicz, PTA
• Nicole F Gaskins, LPC-A, LCMHC-A
• Aimee Gemme
• Gentle Sticks Mobile Phlebotomy
• Taylor Gipson
• Al Glaza
• Connor Owen Glaza, DC
• Madison Elizabeth Harkey, OTR/L
• Alan David Hartley, PH.D., DC
• Ellen Christine Hibberts, PA

• Chiropractor in Lake Wylie, SC
• Providers in Lake Wylie, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.