Organization
CLOUSE CHIROPRACTIC SERVICES LLC
Active
Other names
Moncks Corner Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS A MCCOY DC (MEMBER/PROVIDOR)
(843) 761-4470
Entity
Organization
Contact information
Practice address
112 BROUGHTON RD, SUITE B, MONCKS CORNER, SC 29461-4021
(843) 761-4470
(843) 695-7932
Mailing address
505 N HIGHWAY 52, SUITE D #127, MONCKS CORNER, SC 29461-3151
(843) 761-4470
(843) 695-7932
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3453
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DW2715
RAILROAD MEDICARE GROUP PTAN
SC
Enumeration date
12/09/2014
Last updated
06/16/2016
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