Provider Demographics
NPI:1861896847
Name:RAK SPECIFIC CHIROPRACTIC CLINIC
Entity type:Organization
Organization Name:RAK SPECIFIC CHIROPRACTIC CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:RAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-971-8020
Mailing Address - Street 1:1303 BEN SAWYER BLVD STE 7
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-4589
Mailing Address - Country:US
Mailing Address - Phone:843-971-8020
Mailing Address - Fax:843-971-8285
Practice Address - Street 1:1303 BEN SAWYER BLVD STE 7
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-4589
Practice Address - Country:US
Practice Address - Phone:843-971-8020
Practice Address - Fax:843-971-8285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-20
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2270111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty