Individual
BRIAN T MENNETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
137 EAST 2ND NORTH ST, SUMMERVILLE, SC 29483-6628
(843) 871-7003
(843) 871-0882
Mailing address
PO BOX 3108, SUMMERVILLE, SC 29484-3108
(843) 871-7003
(843) 871-0882
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1793
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
571013904
TAX IDENTIFICATION NUMBER
SC
05
—
CH 1793
—
SC
05
—
GCH 123
—
SC
Enumeration date
05/17/2006
Last updated
12/03/2007
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