Provider Demographics
NPI:1518144724
Name:BURTON, MONICA CHENIQUA (DC)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:CHENIQUA
Last Name:BURTON
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 1:4122 W BELTLINE BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-1509
Mailing Address - Country:US
Mailing Address - Phone:803-254-6730
Mailing Address - Fax:803-254-6323
Practice Address - Street 1:4122 W BELTLINE BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-1509
Practice Address - Country:US
Practice Address - Phone:803-254-6730
Practice Address - Fax:803-254-6323
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3307111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor