Provider Demographics
NPI:1720090186
Name:DR NICHOLE SEARS LLC
Entity Type:Organization
Organization Name:DR NICHOLE SEARS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEARS-QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-641-7075
Mailing Address - Street 1:8988 UNIVERSITY BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9183
Mailing Address - Country:US
Mailing Address - Phone:843-641-7075
Mailing Address - Fax:843-641-7076
Practice Address - Street 1:8988 UNIVERSITY BLVD STE 103
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9183
Practice Address - Country:US
Practice Address - Phone:843-641-7075
Practice Address - Fax:843-641-7076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2990111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH2990Medicaid
SCV11054Medicare UPIN
SCAA15888605Medicare PIN