Organization
WURST CHIROPRACTIC CENTER
Active
Other names
B.L. Black Clinic of Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW R WURST D.C. (OWNER/DOCTOR)
(843) 884-3506
Entity
Organization
Contact information
Practice address
1350 CHUCK DAWLEY BLVD, MT PLEASANT, SC 29464-3380
(843) 884-3506
(843) 856-0912
Mailing address
1350 CHUCK DAWLEY BLVD, MT PLEASANT, SC 29464-3380
(843) 884-3506
(843) 856-0912
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2276
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U767900281
MEDICARE PTAN
SC
Enumeration date
05/25/2011
Last updated
05/25/2011
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