Jessenia Liz Pratts Santiago, | |
403 Parker Ivey Dr, Greenville, SC 29607-6513 | |
(864) 288-2136 | |
Not Available |
Full Name | Jessenia Liz Pratts Santiago |
---|---|
Gender | Female |
Speciality | Chiropractor |
Location | 403 Parker Ivey Dr, Greenville, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1750068326 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 4973 (South Carolina) | Primary |
Provider Name | Life Chiropractic Clinic |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1437322245 PECOS PAC ID: 5597994103 Enrollment ID: O20140130001992 |
Mailing Address | Practice Location Address |
---|---|
Jessenia Liz Pratts Santiago, 620 Halton Rd Apt 7002, Greenville, SC 29607-3484 Ph: (787) 432-0591 | Jessenia Liz Pratts Santiago, 403 Parker Ivey Dr, Greenville, SC 29607-6513 Ph: (864) 288-2136 |
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