Provider Demographics
NPI:1245222314
Name:ORR, REUBEN J (DC)
Entity Type:Individual
Prefix:DR
First Name:REUBEN
Middle Name:J
Last Name:ORR
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 1:1906 INDIA HOOK RD
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-1218
Mailing Address - Country:US
Mailing Address - Phone:803-366-9482
Mailing Address - Fax:803-366-1288
Practice Address - Street 1:1906 INDIA HOOK RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1218
Practice Address - Country:US
Practice Address - Phone:803-366-9482
Practice Address - Fax:803-366-1288
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2476111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCU887248245OtherMEDICARE PROVIDER
SCCH2476Medicaid
SC246689598OtherBLUE CROSS BLUE SHIELD
SC246689598OtherBLUE CROSS BLUE SHIELD