Provider Demographics
NPI:1023087871
Name:ALLEN, JOSEPH ADAM (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ADAM
Last Name:ALLEN
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 1:206 W ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-1602
Mailing Address - Country:US
Mailing Address - Phone:864-877-5431
Mailing Address - Fax:864-877-2991
Practice Address - Street 1:206 W ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-1602
Practice Address - Country:US
Practice Address - Phone:864-877-5431
Practice Address - Fax:864-877-2991
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1676111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH1676Medicaid
SCCH1676Medicaid