Provider Demographics
NPI:1710195367
Name:SENECA CHIROPRACTIC LITE CENTER PA
Entity Type:Organization
Organization Name:SENECA CHIROPRACTIC LITE CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:COMBS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:864-882-7004
Mailing Address - Street 1:1701 SANDIFER BLVD
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29678
Mailing Address - Country:US
Mailing Address - Phone:864-882-7004
Mailing Address - Fax:864-882-7004
Practice Address - Street 1:1701 SANDIFER BLVD
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678
Practice Address - Country:US
Practice Address - Phone:864-882-7004
Practice Address - Fax:864-882-7004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty