Provider Demographics
NPI:1114921780
Name:JONES, ROCHELLE (DC)
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5209 FOREST DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29206-5422
Mailing Address - Country:US
Mailing Address - Phone:803-771-9990
Mailing Address - Fax:
Practice Address - Street 1:5209 FOREST DR
Practice Address - Street 2:SUITE C
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29206-5422
Practice Address - Country:US
Practice Address - Phone:803-771-9990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1187111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH1187Medicaid
SCU312510281Medicare PIN