Organization
SURFSIDE CHIROPRACTIC CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY EDWARD SIMON DC (DR OF CHIROPRACTIC)
(843) 357-3800
Entity
Organization
Contact information
Practice address
3103 HWY 17 SOUTH, GARDEN CITY, SC 29576-7629
(843) 357-3800
(843) 357-3117
Mailing address
3103 HWY 17 SOUTH, GARDEN CITY, SC 29576-7629
(843) 357-3800
(843) 357-3117
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1332
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
616070
UNITED HEALTHCARE
SC
05
—
6CH150
—
SC
05
—
CH1332
—
SC
Enumeration date
10/06/2006
Last updated
08/22/2020
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