Provider Demographics
NPI:1316942279
Name:EULAU, JEFF (DC)
Entity type:Individual
Prefix:DR
First Name:JEFF
Middle Name:
Last Name:EULAU
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 1:119 SPRING HALL DR
Mailing Address - Street 2:STE B
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-5368
Mailing Address - Country:US
Mailing Address - Phone:843-572-9090
Mailing Address - Fax:843-572-7025
Practice Address - Street 1:119 SPRING HALL DR
Practice Address - Street 2:STE B
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-5368
Practice Address - Country:US
Practice Address - Phone:843-572-9090
Practice Address - Fax:843-572-7025
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2419111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGCH396Medicaid
SCCH2419Medicaid
SCGCH396Medicaid
SCCH2419Medicaid