Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 3786 | SC |
N | 111NP0017X | Pediatric Chiropractor | 3786 | SC |
NPI | 1669716007 |
---|---|
Provider Name | Dr. Christopher Allen Shumate |
First Address | Little River, SC 29566-6843 |
Second Address | Little River, SC 29566-6843 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2012 |
Last Update Date | 26/11/2012 |