Provider Demographics
NPI:1154452738
Name:JENKINS, JAMES MATTHEW (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MATTHEW
Last Name:JENKINS
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 1:2294 OTRANTO RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9603
Mailing Address - Country:US
Mailing Address - Phone:843-225-2550
Mailing Address - Fax:843-225-2590
Practice Address - Street 1:2294 OTRANTO RD
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9603
Practice Address - Country:US
Practice Address - Phone:843-225-2550
Practice Address - Fax:843-225-2590
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC208532346111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor