Provider Demographics
NPI:1104289412
Name:PRECISION CHIROPRACTIC SPARTANBURG LLC
Entity type:Organization
Organization Name:PRECISION CHIROPRACTIC SPARTANBURG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUTRUMPF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:720-352-7330
Mailing Address - Street 1:1200 E MAIN ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29307-1711
Mailing Address - Country:US
Mailing Address - Phone:864-256-3312
Mailing Address - Fax:
Practice Address - Street 1:1200 E MAIN ST
Practice Address - Street 2:SUITE 5
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307-1711
Practice Address - Country:US
Practice Address - Phone:864-256-3312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-04
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4086261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center