MEDICARE: THE CHIROPRACTIC CENTER OF MAULDIN INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	0883	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336110618
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CHIROPRACTIC CENTER OF MAULDIN INC.

Provider Business Mailing Address
First Line	:	PO BOX 982
Second Line	:
City	:	MAULDIN
State	:	SC
Zip	:	29662-0982
Country	:	US
Telephone Number	:	864-297-6270
Fax Number	:	864-288-9010

Provider Business Practice Location Address
First Line	:	14C E BUTLER RD
Second Line	:
City	:	MAULDIN
State	:	SC
Zip	:	29662-2402
Country	:	US
Telephone Number	:	864-297-6270
Fax Number	:	864-288-9010

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. JAMES D. MAYES JR.
Credential	:	D.C.
Telephone Number	:	864-297-6270

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	08/22/2020

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