Individual
CHARLES WAPNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1120 STATE ST, HOLLY HILL, SC 29059-2611
(803) 496-3338
(803) 496-9229
Mailing address
PO BOX 1487, HOLLY HILL, SC 29059-1487
(803) 496-3338
(803) 496-9229
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1241
NC
111N00000X
Chiropractor
Primary
803
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CHO803 GCH182
MEDICAID PROVIDER
—
01
—
T236342211
PROVIDER NUMBER
—
Enumeration date
03/17/2006
Last updated
10/07/2010
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