Chiropractic and physical therapy practices in South Carolina

South Carolina had 620 offices of chiropractors with paid employees in 2023, according to the U.S. Census Bureau's County Business Patterns (CBP), NAICS 621310. They employed 2,219 people in the March 2023 pay period and paid $80.9 million in annual payroll.

Against the Census Bureau's Vintage 2024 population estimate of 5,478,831, that is 1.13 chiropractic offices per 10,000 residents. The U.S. rate is 1.14 (38,698 offices for 340.1 million people), so the state is at the national level.

The count understates the number of chiropractors in practice. The Bureau of Labor Statistics Occupational Outlook Handbook reports that 36% of chiropractors are self-employed, and a solo chiropractor with no staff on payroll does not appear in CBP.

South Carolina had 710 offices of physical, occupational and speech therapists and audiologists (NAICS 621340) with paid employees in 2023. They employed 4,609 people and paid $223.5 million in annual payroll.

That is 1.30 offices per 10,000 residents, against 1.50 nationally (50,940 offices). South Carolina has about 13% fewer outpatient therapy offices per resident than the U.S. Hospital-based outpatient therapy departments are counted under hospitals, so residents in some counties are served by hospital systems rather than independent clinics.

Charleston County has the highest combined density at 4.27 practices per 10,000 residents (184 offices), followed by Greenville County at 3.84 (219 offices, the largest count in the state). Georgetown, Beaufort and York counties also exceed 3.3 per 10,000.

Coastal counties rank high. Georgetown (3.48) and Beaufort (3.37) both have more practices per resident than Richland County, home to Columbia, which sits below the state average at 1.90 per 10,000. Richland's gap is mostly in chiropractic: 33 offices, or 0.77 per 10,000, against 1.13 statewide.

The split between the two specialties varies by county. Greenville and York have roughly as many chiropractic offices as therapy offices, while Beaufort has more than twice as many therapy offices (48) as chiropractic offices (20) and Berkeley has 34 against 20. A chiropractor scanning for an opening should look at the chiropractic column on its own, since a therapy-heavy county can still be thin on chiropractic care.

Several of the fastest-growing counties have fewer practices per resident than the state's 2.43. We flagged counties with at least 25,000 residents whose 2020 to 2024 growth beat the county median (2.75%) and whose combined density was below the state rate.

Horry County is the largest gap by volume. It added 62,353 residents from 2020 to 2024 and has 2.39 practices per 10,000. A Census Bureau analysis of county migration noted that older Americans drove high rates of domestic migration into Horry County in earlier years (2016 to 2018). Berkeley County (2.04) and Spartanburg County (2.14) are similar: large, fast-growing and under the state rate.

• Horry County: 99 practices, 2.39 per 10,000, population up 17.8%.
• Lancaster County: 21 practices, 1.88 per 10,000, up 16.3%.
• Berkeley County: 54 practices, 2.04 per 10,000, up 15.0%.
• Spartanburg County: 79 practices, 2.14 per 10,000, up 12.6%.
• Kershaw County: 4 practices, 0.56 per 10,000, up 9.6%.
• Jasper County: 3 practices, 0.84 per 10,000, up 23.7%; Edgefield County (up 14.9%) had none.

Sixteen counties had no employer office in either code in 2023: Allendale, Bamberg, Barnwell, Calhoun, Chester, Chesterfield, Clarendon, Edgefield, Fairfield, Hampton, Laurens, Lee, McCormick, Saluda, Union and Williamsburg. Laurens County is the largest, with 70,545 residents.

Residents of these counties travel to a neighboring county, use hospital outpatient services or see a solo provider who has no payroll. For a practice in an adjacent county, these areas are part of the real trade area, and a location page and a Google Business Profile service area that names them can help those patients find you.

Chiropractic offices in South Carolina are small: 3.6 employees per office on average, and 75.2% of those with a published size class had fewer than 5 employees, identical to the U.S. share. Therapy offices are larger at 6.5 employees, but well below the U.S. average of 9.0. Only 2.8% of South Carolina therapy offices with a published size class had 20 or more employees, against 5.9% nationally.

The workforce outlook favors growth. The Bureau of Labor Statistics projects employment of physical therapists to grow 12% from 2025 to 2035 and of chiropractors to grow 9%, both well above the 3% average for all occupations. BLS reports a May 2025 median annual wage of $102,760 for physical therapists and $79,200 for chiropractors.

Smaller offices in a growing market usually run with a lean front desk, and that is where patient acquisition often breaks down: missed calls during treatment hours, slow replies to web inquiries and no follow-up after a first visit.

In dense markets such as Charleston, Greenville and York, a new patient has several options within a short drive, and the practice that answers first, shows real reviews and offers online booking usually wins the visit. In fast-growing, thinner markets such as Horry, Berkeley and Lancaster, the task is being discovered by residents who just moved and are searching for a provider for the first time.

Retention matters in both. A plan of care only works if patients return for the visits it calls for, so appointment reminders and rebooking prompts protect revenue that is already earned. Monvell builds the booking, reminder and missed-call systems health and wellness practices use, and can map this county data against your current patient addresses.

• Compare your county with the state rate of 2.43 practices per 10,000.
• List the neighboring counties with no practice and decide whether to serve them.
• Measure how many calls go unanswered during treatment hours.
• Check that your Google Business Profile, website location pages and directory listings name the towns your newest patients are moving into.
• Track how many first visits turn into a completed plan of care, by referral source.

Dataset: U.S. Census Bureau County Business Patterns 2023, county file (cbp23co.txt, released June 2025), NAICS 621310 Offices of Chiropractors and 621340 Offices of Physical, Occupational and Speech Therapists, and Audiologists. Population: Census Bureau Population Estimates Vintage 2024 county file (co-est2024-alldata.csv).

Method: we summed establishments, March employment and annual payroll by county and code, then divided establishments by the July 1, 2024 population. State totals include 7 establishments CBP lists as statewide rather than in a county. The U.S. rate sums every county row for each code and divides by the population of the 50 states and the District of Columbia. Growth is the 2024 estimate over the April 1, 2020 base, minus one. Size shares use establishments with a published size class (588 of 620 chiropractic and 649 of 710 therapy offices).

Limits: CBP counts employer establishments only, so self-employed providers with no staff are excluded. Therapy departments inside hospitals and home health agencies are coded elsewhere. NAICS 621340 also includes speech therapists and audiologists, so it is broader than physical therapy. CBP employment is noise-infused and counts full- and part-time staff. BLS figures are national. Population figures are Vintage 2024; Vintage 2025 has since been released.