Provider Demographics
NPI:1548434962
Name:ALLISON, BEVERLY (DC)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
Last Name:ALLISON
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 1:634 GARVIN LAKE RD
Mailing Address - Street 2:
Mailing Address - City:GAFFNEY
Mailing Address - State:SC
Mailing Address - Zip Code:29340-5156
Mailing Address - Country:US
Mailing Address - Phone:803-225-4264
Mailing Address - Fax:
Practice Address - Street 1:800 COLUMBIANA DR
Practice Address - Street 2:SUITE 100
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-7213
Practice Address - Country:US
Practice Address - Phone:803-225-4264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1487111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor