Individual
DR. TY WESLEY MAXIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
5750 RIVERS AVE STE A, NORTH CHARLESTON, SC 29406-6029
(843) 723-6475
Mailing address
1235 ASHLEY GARDEN BLVD UNIT 1022, CHARLESTON, SC 29414-9212
(812) 216-8964
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5037
SC
Other
Enumeration date
01/11/2024
Last updated
01/11/2024
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