Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2546 | SC |
NPI | 1003993395 |
---|---|
Provider Name | Misty Ann Geiyer |
First Address | Simpsonville, SC 29680-6706 |
Second Address | Simpsonville, SC 29681-2342 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CH2546 | (05) | SC |