Provider Demographics
NPI:1295295889
Name:WALTON FAMILY CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:WALTON FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPACTIC PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:WALTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-508-8181
Mailing Address - Street 1:126 WARLEY ST STE A
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-4443
Mailing Address - Country:US
Mailing Address - Phone:843-508-8181
Mailing Address - Fax:803-626-1474
Practice Address - Street 1:126 WARLEY ST STE A
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4443
Practice Address - Country:US
Practice Address - Phone:843-508-8181
Practice Address - Fax:803-626-1474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
No111NP0017XChiropractic ProvidersChiropractorPediatric ChiropractorGroup - Single Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
No111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty