Organization
SPRING VALLEY CHIROPRACTIC
Active
Other names
Gary S Weaver DC
Organization subpart
No
Provider details
NPI number
Authorized official
GARY S WEAVER CCSP DABCO DABFP (OWNER DOCTOR)
(803) 736-2200
Entity
Organization
Contact information
Practice address
9570 TWO NOTCH RD, STE 1, COLUMBIA, SC 29223-4309
(803) 736-2200
(803) 736-2201
Mailing address
9570 TWO NOTCH RD, STE 1, COLUMBIA, SC 29223-4309
(803) 736-2200
(803) 736-2201
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1037
SC
111NS0005X
Sports Physician Chiropractor
1037
SC
111NX0800X
Orthopedic Chiropractor
1037
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DF 1270
MEDICARE GROUP
SC
05
—
GCH120
—
SC
Enumeration date
08/20/2007
Last updated
12/12/2007
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