Individual
DR. JUSTIN BLAKE MEDFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
551 COLLEGE PARK RD, LADSON, SC 29456-3329
(843) 572-2224
Mailing address
551 COLLEGE PARK RD, LADSON, SC 29456-3329
(843) 572-2224
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4370
SC
Other
Enumeration date
09/17/2018
Last updated
02/12/2021
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