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Individual

DR. MARTIN LAYNE SHEALY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
76 IRVING STREET, BARNWELL, SC 29812
(803) 259-9412
(803) 259-0559
Mailing address
76 IRVING STREET, BARNWELL, SC 29812
(803) 259-9412
(803) 259-0559

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2275
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
582422361
FEDERAL TAX ID
Enumeration date
11/28/2006
Last updated
03/29/2010
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