Organization
COXON LIFESTYLE MANAGEMENT CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADAM MARK COXON DC (PRESIDENT)
(803) 370-4294
Entity
Organization
Contact information
Practice address
1012 MARKET ST, SUITE 101, FORT MILL, SC 29708-6461
(803) 370-4294
Mailing address
1012 MARKET ST, SUITE 101, FORT MILL, SC 29708-6461
(803) 370-4294
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3419
SC
111N00000X
Chiropractor
3702
SC
Other
Enumeration date
02/16/2012
Last updated
02/16/2012
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