Organization
LIFE LINE CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAMMY L COSTELLO D.C. (OWNER)
(843) 839-5588
Entity
Organization
Contact information
Practice address
LIFE LINE CHIROPRACTIC, 1151 ROBERT GRISSOM PKWY, MYRTLE BEACH, SC 29577
(843) 839-5588
(843) 839-5591
Mailing address
LIFE LINE CHIROPRACTIC, 1151 ROBERT GRISSOM PKWY, MYRTLE BEACH, SC 29577
(843) 839-5588
(843) 839-5591
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
SC2755
SC
Other
Enumeration date
12/13/2006
Last updated
05/11/2009
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