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Organization
REVIVE CHIROPRACTIC PC
Active
Organization
REVIVE CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUKE MACKINNON DC (PRESIDENT)
(803) 802-2225
Entity
Organization
Contact information
Practice address
1808 SECOND BAXTER XING, STE 108, FORT MILL, SC 29708-6436
(803) 802-2225
(803) 802-2275
Mailing address
1808 SECOND BAXTER XING, STE 108, FORT MILL, SC 29708-6436
(803) 802-2225
(803) 802-2275
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2757
SC
Other
Enumeration date
08/07/2014
Last updated
08/07/2014
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