# CAROLINA SPINE AND SPORT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114572518
- **Authorized official:** DR. DEV'N MORAN DC (DOCTOR)
- **Authorized official phone:** (918) 728-0201

## Contact information

- **Practice address:** 946 ORLEANS RD UNIT B10, CHARLESTON, SC 29407-4839
- **Practice address phone:** (918) 728-0201
- **Mailing address:** 1871 ASHLEY RIVER RD APT 4311, CHARLESTON, SC 29407-8724
- **Mailing address phone:** (918) 728-0201

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NR0400X | Rehabilitation Chiropractor | — | NULL | Yes |
| 111NR0400X | Rehabilitation Chiropractor | — | — | Yes |

## Other

- **Enumeration date:** 08/03/2019
- **Last updated:** 08/03/2019