Provider Demographics
NPI:1518360478
Name:PRECISION CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:PRECISION CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:PERO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-376-7024
Mailing Address - Street 1:330 E 5TH NORTH ST
Mailing Address - Street 2:STE A
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-0702
Mailing Address - Country:US
Mailing Address - Phone:843-376-7024
Mailing Address - Fax:864-751-5940
Practice Address - Street 1:330 E 5TH NORTH ST
Practice Address - Street 2:STE A
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-0702
Practice Address - Country:US
Practice Address - Phone:843-376-7024
Practice Address - Fax:864-751-5940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3827111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1427494814OtherNPPES, INVIDUAL PROVIDER NPI