Organization
CAROLINA SPORTS CLINIC-FORT MILL,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY WEIST (MANAGER)
(803) 547-9800
Entity
Organization
Contact information
Practice address
985 MARKET ST, SUITE 201, FORT MILL, SC 29708-6532
(704) 449-6601
(980) 225-7914
Mailing address
985 MARKET ST, SUITE 201, FORT MILL, SC 29708-6532
(803) 547-9800
(803) 547-9804
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3905
SC
Other
Enumeration date
07/24/2015
Last updated
09/28/2015
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