Provider Demographics
NPI:1548236516
Name:SEARS-QUINN, NICHOLE D (DC)
Entity Type:Individual
Prefix:DR
First Name:NICHOLE
Middle Name:D
Last Name:SEARS-QUINN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MRS
Other - First Name:NICHOLE
Other - Middle Name:
Other - Last Name:SEARS-QUINN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2750 DANTZLER DRIVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406
Mailing Address - Country:US
Mailing Address - Phone:843-553-9700
Mailing Address - Fax:843-553-9731
Practice Address - Street 1:2750 DANTZLER DRIVE
Practice Address - Street 2:SUITE 101
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406
Practice Address - Country:US
Practice Address - Phone:843-553-9700
Practice Address - Fax:843-553-9731
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2990111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH2990Medicaid
V11054Medicare UPIN
SCAA15888605Medicare PIN