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Organization
SURFSIDE CHIROPRACTIC CENTER INC
Active
Organization
SURFSIDE CHIROPRACTIC CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY EDWARD SIMON DC (DR OF CHIROPRACTIC)
(843) 357-3800
Entity
Organization
Contact information
Practice address
3103 HWY 17 SOUTH, GARDEN CITY, SC 29576-7629
(843) 357-3800
(843) 357-3117
Mailing address
3103 HWY 17 SOUTH, GARDEN CITY, SC 29576-7629
(843) 357-3800
(843) 357-3117
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1332
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
616070
UNITED HEALTHCARE
SC
05
—
6CH150
—
SC
05
—
CH1332
—
SC
Enumeration date
10/06/2006
Last updated
08/22/2020
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