Organization
AMERICAN TELECOMMUNTIONS GROUP, INC.
Active
Other names
Edisto/Allendale Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK JOHNSON (MANAGER)
(803) 534-7100
Entity
Organization
Contact information
Practice address
1050 CHESTNUT ST, ORANGEBURG, SC 29115-3508
(803) 534-7100
(803) 534-7184
Mailing address
PO BOX 507, ORANGEBURG, SC 29116-0507
(803) 534-7100
(803) 534-7184
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1640
SC
111NR0400X
Rehabilitation Chiropractor
1640
SC
111NS0005X
Sports Physician Chiropractor
1640
SC
133NN1002X
Nutrition Education Nutritionist
1640
SC
207Q00000X
Family Medicine Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GRP 385
—
SC
Enumeration date
02/13/2008
Last updated
02/13/2008
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