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Organization
MYRTLE BEACH SPINE CENTER, PA
Active
Organization
MYRTLE BEACH SPINE CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL P GAMBACORTA DC, FNP-BC (OWNER)
(843) 236-9090
Entity
Organization
Contact information
Practice address
100 LEGENDS RD SUITE A, MYRTLE BEACH, SC 29579-7076
(843) 236-9090
(843) 236-9099
Mailing address
100 LEGENDS RD STE A, MYRTLE BEACH, SC 29579-7076
(919) 394-3225
(843) 236-9099
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NULL
111N00000X
Chiropractor
—
—
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
NULL
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
NULL
Other
Enumeration date
06/13/2012
Last updated
09/05/2024
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