Provider Demographics
NPI:1730699414
Name:MEMMINGER, WAYNE MORRIS (DC)
Entity type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:MORRIS
Last Name:MEMMINGER
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 1:101 LANDS END RD
Mailing Address - Street 2:
Mailing Address - City:WALTERBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29488-3748
Mailing Address - Country:US
Mailing Address - Phone:843-782-4575
Mailing Address - Fax:843-782-4575
Practice Address - Street 1:101 LANDS END RD
Practice Address - Street 2:
Practice Address - City:WALTERBORO
Practice Address - State:SC
Practice Address - Zip Code:29488-3748
Practice Address - Country:US
Practice Address - Phone:843-782-4575
Practice Address - Fax:843-782-4575
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-06
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4206111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty