1710323118 NPI number — BRIGGS CHIROPRACTIC CLINIC LLC

Table of content: (NPI 1710323118)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710323118 NPI number — BRIGGS CHIROPRACTIC CLINIC LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRIGGS CHIROPRACTIC CLINIC LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LOWER RICHLAND CHIROPRACTIC & SPINAL REHAB
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710323118
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/30/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 91101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29290-2101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-764-3072
Provider Business Mailing Address Fax Number:
803-764-5362

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6941 N TRENHOLM RD STE O101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29206-1715
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-764-3072
Provider Business Practice Location Address Fax Number:
803-764-5362
Provider Enumeration Date:
05/13/2013

Additional Information

Authorized Official

Authorized Official Last Name:
BRIGGS
Authorized Official First Name:
LAFAYETTE
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIROPRACTOR
Authorized Official Telephone Number:
803-764-3072

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  1206 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com