Provider Demographics
NPI:1063771665
Name:HIGGINS-FORDREE, JANICE L (DC)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:L
Last Name:HIGGINS-FORDREE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 COBBLESTONE DR
Mailing Address - Street 2:
Mailing Address - City:INMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29349-7186
Mailing Address - Country:US
Mailing Address - Phone:864-590-8595
Mailing Address - Fax:
Practice Address - Street 1:428 COBBLESTONE DR
Practice Address - Street 2:
Practice Address - City:INMAN
Practice Address - State:SC
Practice Address - Zip Code:29349-7186
Practice Address - Country:US
Practice Address - Phone:864-590-8595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1391111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor