Basic Information
| Provider Information | |||||||||
| NPI: | 1003143876 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STANTON | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | KEMPER | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | D.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 115 WILLBROOK BLVD | ||||||||
| Address2: | SUITE N | ||||||||
| City: | PAWLEYS ISLAND | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295856541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437500806 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 115 WILLBROOK BLVD | ||||||||
| Address2: | SUITE N | ||||||||
| City: | PAWLEYS ISLAND | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295856541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437500806 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2009 | ||||||||
| LastUpdateDate: | 11/15/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 3490 | SC | Y | Chiropractic Providers | Chiropractor |
No ID Information.