Organization
LIFE WELLNESS LLC
Active
Other names
Life Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS TAYLOR BLAKE JR. DC (OWNER)
(803) 520-8631
Entity
Organization
Contact information
Practice address
4715 SUNSET BLVD STE C, LEXINGTON, SC 29072-9151
(803) 520-8631
(803) 520-8634
Mailing address
4715 SUNSET BLVD STE C, LEXINGTON, SC 29072-9151
(803) 520-8631
(803) 520-8634
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3261
SC
Other
Enumeration date
01/27/2012
Last updated
01/27/2012
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