Provider Demographics
NPI:1770791329
Name:COMBS, JEROME ROBERT (DC)
Entity type:Individual
Prefix:DR
First Name:JEROME
Middle Name:ROBERT
Last Name:COMBS
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 1:1701 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
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC662111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor