Organization
SHADY GROVE CHIROPRACTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFERY DALE TOUCHET II D.C. (PRESIDENT)
(803) 781-0031
Entity
Organization
Contact information
Practice address
11134 BROAD RIVER RD STE C, IRMO, SC 29063-7616
(803) 781-0031
(803) 781-0032
Mailing address
PO BOX 184, BALLENTINE, SC 29002-0184
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2611
SC
Other
Enumeration date
06/02/2010
Last updated
06/02/2010
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