Healthcare Provider Details

I. General information

NPI: 1760982193
Provider Name (Legal Business Name): JOSEPH CIPRIANO DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2018
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 REGENT PARK CT
GREENVILLE SC
29607-6547
US

IV. Provider business mailing address

300 REGENT PARK CT
GREENVILLE SC
29607-6547
US

V. Phone/Fax

Practice location:
  • Phone: 864-437-8930
  • Fax: 864-309-8004
Mailing address:
  • Phone: 864-437-8930
  • Fax: 864-309-8004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4297
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: