Provider Demographics
NPI:1902111404
Name:FILTER, BRIAN WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:WAYNE
Last Name:FILTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 DEVINE STREET
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-2804
Mailing Address - Country:US
Mailing Address - Phone:803-787-7050
Mailing Address - Fax:
Practice Address - Street 1:3930 DEVINE STREET
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-2804
Practice Address - Country:US
Practice Address - Phone:803-787-7050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-10
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3562111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor