Provider Demographics
NPI:1194950105
Name:GASPAROVICH, CLAY T (DC)
Entity type:Individual
Prefix:DR
First Name:CLAY
Middle Name:T
Last Name:GASPAROVICH
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 1:1924 MT GALLANT RD
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-9434
Mailing Address - Country:US
Mailing Address - Phone:704-438-9700
Mailing Address - Fax:803-323-5501
Practice Address - Street 1:1924 MT GALLANT RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-9434
Practice Address - Country:US
Practice Address - Phone:704-438-9700
Practice Address - Fax:803-323-5501
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-19
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3942111N00000X
SC3622111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3942OtherLICENSE
SC3622OtherSTATE OF SOUTH CAROLINA BOARD OF CHIROPRACTIC EXAMINERS