Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 786 | SC |
N | 111NR0400X | Rehabilitation Chiropractor | 786 | SC |
NPI | 1306967690 |
---|---|
Provider Name | Dr. Steven Gregory Mathis |
First Address | Greer, SC 29651-1818 |
Second Address | Greer, SC 29651-1818 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 08/07/2007 |