Individual
JON LLOYD ETHERIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1711 N MAIN ST, SUMMERVILLE, SC 29483-7807
(843) 875-2268
(843) 875-2267
Mailing address
1711 N MAIN ST, SUMMERVILLE, SC 29483-7807
(843) 875-2268
(843) 875-2267
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1243
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CH1243
—
SC
Enumeration date
04/12/2006
Last updated
08/02/2007
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