Provider Demographics
NPI:1386164903
Name:COMMUNITY CHIRO SC LLC
Entity type:Organization
Organization Name:COMMUNITY CHIRO SC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:WALLACE
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:864-621-9763
Mailing Address - Street 1:202 W JAMES ST
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-2331
Mailing Address - Country:US
Mailing Address - Phone:864-621-9763
Mailing Address - Fax:
Practice Address - Street 1:812 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651-1206
Practice Address - Country:US
Practice Address - Phone:864-621-9763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-24
Last Update Date:2017-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4111111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty