Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 3991 | SC |
N | 111NI0013X | Independent Medical Examiner | 3991 | SC |
N | 111NR0400X | Rehabilitation Chiropractor | 3991 | SC |
NPI | 1881099760 |
---|---|
Provider Name | Dr. George Andrew Warren |
First Address | Newberry, SC 29108-9137 |
Second Address | Newberry, SC 29108-9137 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2014 |
Last Update Date | 14/06/2017 |