Healthcare Provider Details

I. General information

NPI: 1225160302
Provider Name (Legal Business Name): JFB ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 01/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 S FOURTH ST
HARTSVILLE SC
29550-4307
US

IV. Provider business mailing address

331 S FOURTH ST
HARTSVILLE SC
29550-4307
US

V. Phone/Fax

Practice location:
  • Phone: 843-332-6191
  • Fax: 843-332-4408
Mailing address:
  • Phone: 843-332-6191
  • Fax: 843-332-4408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2622
License Number StateSC

VIII. Authorized Official

Name: DR. JOHN F BRYAN JR.
Title or Position: OWNER
Credential: D.C.
Phone: 843-332-6191