Provider Demographics
NPI:1508219817
Name:JANES, CHAD (DC)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:JANES
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 1:1104 SPRINGFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29316-9328
Mailing Address - Country:US
Mailing Address - Phone:810-623-2643
Mailing Address - Fax:
Practice Address - Street 1:107 E PARK AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-1631
Practice Address - Country:US
Practice Address - Phone:810-623-2643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-21
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4164111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor