Provider Demographics
NPI:1932169281
Name:RISING, JAY W (DC)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:W
Last Name:RISING
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 1:303 SILVER BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-6007
Mailing Address - Country:US
Mailing Address - Phone:803-226-0522
Mailing Address - Fax:803-226-0522
Practice Address - Street 1:303 SILVER BLUFF RD
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-6007
Practice Address - Country:US
Practice Address - Phone:803-226-0522
Practice Address - Fax:803-226-0522
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1306111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC236966503OtherBLUE CROSS
U41645Medicare UPIN
SCU416454172Medicare ID - Type Unspecified
SCCH1306Medicaid