Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 3490 | SC |
NPI | 1003143876 |
---|---|
Provider Name | Dr. John Kemper Stanton III |
First Address | Pawleys Island, SC 29585-6541 |
Second Address | Pawleys Island, SC 29585-6541 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2009 |
Last Update Date | 15/11/2009 |