Dr Jack Chiropractor Inc | |
6335c Calhoun Memorial Hwy Ste C Easley SC 29640-3784 | |
(864) 859-8282 | |
(864) 859-3628 |
Full Name | Dr Jack Chiropractor Inc |
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Speciality | Clinic/Center |
Location | 6335c Calhoun Memorial Hwy Ste C, Easley, South Carolina |
Authorized Official Name and Position | Jack Edward Newsome (OWNER) |
Authorized Official Contact | 8646070197 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dr Jack Chiropractor Inc 6335c Calhoun Memorial Hwy Ste C Easley SC 29640-3784 Ph: (864) 859-8282 | Dr Jack Chiropractor Inc 6335c Calhoun Memorial Hwy Ste C Easley SC 29640-3784 Ph: (864) 859-8282 |
NPI Number | 1356836753 |
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Provider Enumeration Date | 06/27/2018 |
Last Update Date | 06/27/2018 |
Medicare PECOS PAC ID | 0446597496 |
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Medicare Enrollment ID | O20190129001377 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356836753 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 2259 (South Carolina) | Primary |
Provider Name | Jack E Newsome |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1356384879 PECOS PAC ID: 1052320918 Enrollment ID: I20190213002685 |
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