Provider Demographics
NPI:1487930392
Name:SCHILSKY, SUEZEN ROFF (DC)
Entity type:Individual
Prefix:
First Name:SUEZEN
Middle Name:ROFF
Last Name:SCHILSKY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E ROOSEVELT ST
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:SC
Mailing Address - Zip Code:29536-2516
Mailing Address - Country:US
Mailing Address - Phone:843-340-7088
Mailing Address - Fax:843-841-9884
Practice Address - Street 1:200 E ROOSEVELT ST
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:SC
Practice Address - Zip Code:29536-2516
Practice Address - Country:US
Practice Address - Phone:843-340-7088
Practice Address - Fax:843-841-9884
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-25
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2342111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor