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Organization

LAKE WYLIE FAMILY CHIROPRACTIC INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALAN D HARTLEY PH.D., DC (PRESIDENT)
(803) 831-6500
Entity
Organization

Contact information

Practice address
244 LATITUDE LN, SUITE 104, CLOVER, SC 29710-8124
(803) 831-6500
(803) 831-6383
Mailing address
244 LATITUDE LN, SUITE 104, CLOVER, SC 29710-8124
(803) 831-6500
(803) 831-6383

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2361
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
CH2361
SC
05
GCH347
SC
Enumeration date
09/21/2006
Last updated
09/11/2012
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