Provider Demographics
NPI:1992989644
Name:COMMUNITY CHIROPRACTIC
Entity type:Organization
Organization Name:COMMUNITY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAUMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:864-859-7900
Mailing Address - Street 1:1097 S PENDLETON ST
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29642-1040
Mailing Address - Country:US
Mailing Address - Phone:864-859-7900
Mailing Address - Fax:864-859-7999
Practice Address - Street 1:1097 S PENDLETON ST
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29642-1040
Practice Address - Country:US
Practice Address - Phone:864-859-7900
Practice Address - Fax:864-859-7999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2632111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T81608Medicare UPIN
7280Medicare PIN