Provider Demographics
NPI:1194728386
Name:KASIC, ANDREW JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JOSEPH
Last Name:KASIC
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 EBENEZER RD
Mailing Address - Street 2:STE 101
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732
Mailing Address - Country:US
Mailing Address - Phone:803-366-8600
Mailing Address - Fax:803-366-8877
Practice Address - Street 1:1430 EBENEZER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732
Practice Address - Country:US
Practice Address - Phone:803-366-8600
Practice Address - Fax:803-366-8877
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2504111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH2504Medicaid
SC62059Medicare UPIN
SCU620590281Medicare ID - Type Unspecified