MEDICARE: CHIROPRACTIC WELLNESS CENTER 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	1187	SC

General Provider Information

NPI Number	:	1699786509
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROPRACTIC WELLNESS CENTER INC.

Provider Business Mailing Address
First Line	:	5209 FOREST DR
Second Line	:	SUITE C
City	:	COLUMBIA
State	:	SC
Zip	:	29206-5422
Country	:	US
Telephone Number	:	803-771-9990
Fax Number	:

Provider Business Practice Location Address
First Line	:	5209 FOREST DR
Second Line	:	SUITE C
City	:	COLUMBIA
State	:	SC
Zip	:	29206-5422
Country	:	US
Telephone Number	:	803-771-9990
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CHIROPRACTOR
Name	:	DR. ROCHELLE JONES
Credential	:	D.C.
Telephone Number	:	803-771-9990

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	11/20/2014

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