NPI 1790748150 · live from the CMS NPI Registry
Advanced Medical Associates Of Summerville
Chiropractor in Summerville, SC. National Provider Identifier 1790748150, active.
NPI record
| NPI | 1790748150 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Chiropractor 111N00000X |
| Practice location | 1711 N Main St, Summerville, SC 29483 |
| Practice phone | 843-875-2268 |
| Enumerated | April 7, 2006 |
| Last updated | March 7, 2023 |
| Authorized official | Jon Etheridge, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice | 208D00000X | 15987 (SC) |
| Physical Therapist | 225100000X | 5123 (SC) |
| Chiropractor primary | 111N00000X | 1243 (SC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.