Organization Name: | EVERGREEN WELLNESS, LLC |
NPI Number: | 1225315633 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JERRY D NASHMAN (OWNER) |
Mailing Address: | 14 E Butler Rd Ste C Mauldin |
State: | SC US |
Postal Code: | 296622402 |
Phone Number: | 8642976270 |
Fax Number: | 8645099378 |
NPI Enumeration Date: | 11/14/2011 |
NPI Last Update Date: | 12/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 3675 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |