Organization
WATEREE CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DURHAM RUSSELL MAPLES D.C. (GENERAL PARTNER)
(803) 438-1177
Entity
Organization
Contact information
Practice address
810 RIDGEWAY ROAD, LUGOFF, SC 29078-0248
(803) 438-1177
Mailing address
PO BOX 248, LUGOFF, SC 29078-0248
(803) 438-1177
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1266
SC
Other
Enumeration date
08/16/2007
Last updated
08/16/2007
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