Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 1637 | SC |
NPI | 1396915716 |
---|---|
Provider Name | Mrs. Nancy S St John |
First Address | Easley, SC 29640-2104 |
Second Address | Easley, SC 29640-2104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2008 |
Last Update Date | 25/02/2020 |