Healthcare Provider Details

I. General information

NPI: 1538664792
Provider Name (Legal Business Name): JONATHAN QUINN WARD DC, MS, DIBCN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date: 04/23/2018
Reactivation Date: 05/02/2018

III. Provider practice location address

6650 RIVERS AVE STE 100
NORTH CHARLESTON SC
29406-4809
US

IV. Provider business mailing address

6650 RIVERS AVE STE 100
NORTH CHARLESTON SC
29406-4809
US

V. Phone/Fax

Practice location:
  • Phone: 843-560-5880
  • Fax:
Mailing address:
  • Phone: 843-560-5880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4882
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4510
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number4882
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number4510
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: