Provider Demographics
NPI:1306808621
Name:GELARDI, JOSHUA BARTLETT (DC)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:BARTLETT
Last Name:GELARDI
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 1:209 BROWN ST
Mailing Address - Street 2:
Mailing Address - City:GAFFNEY
Mailing Address - State:SC
Mailing Address - Zip Code:29341-2361
Mailing Address - Country:US
Mailing Address - Phone:864-487-5437
Mailing Address - Fax:864-487-8886
Practice Address - Street 1:209 BROWN ST
Practice Address - Street 2:
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29341-2361
Practice Address - Country:US
Practice Address - Phone:864-487-5437
Practice Address - Fax:864-487-8886
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1518111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH1518Medicaid
SCU23911Medicare UPIN