Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 692 | SC |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 692 | SC |
NPI | 1558371765 |
---|---|
Provider Name | Dr. Henry William Hulteen JR. |
First Address | Camden, SC 29020-4211 |
Second Address | Camden, SC 29020-4211 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CH0692 | (05) | SC |