# DAIL CHIROPRACTIC CLINIC PA

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

## Provider details

- **NPI number:** 1134160054
- **Authorized official:** DR. LARRY EUGENE DAIL JR. DC (PRESIDENT)
- **Authorized official phone:** (803) 772-8680

## Contact information

- **Practice address:** 1655 BROAD RIVER RD, COLUMBIA, SC 29210-7395
- **Practice address phone:** (803) 772-8680
- **Practice address fax:** (803) 772-5241
- **Mailing address:** 1655 BROAD RIVER RD, COLUMBIA, SC 29210-7303
- **Mailing address phone:** (803) 772-8680
- **Mailing address fax:** (803) 772-5241

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | C0583 | SC | Yes |

## Other

- **Enumeration date:** 06/10/2006
- **Last updated:** 05/21/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | $$$$$$$$$ | SSN | — |