| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 06/27/2018 |
| Last Update Date | 06/27/2018 |
| Medicare PECOS PAC ID | 0446597496 |
|---|---|
| Medicare Enrollment ID | O20190129001377 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356836753 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2259 (South Carolina) | Primary |
| Provider Name | Jack E Newsome |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1356384879 PECOS PAC ID: 1052320918 Enrollment ID: I20190213002685 |
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