Healthcare Provider Details

I. General information

NPI: 1811996101
Provider Name (Legal Business Name): JAMES GILBERT KANE III D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 07/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

679 ORANGEBURG RD
SUMMERVILLE SC
29483
US

IV. Provider business mailing address

320 CLUB VIEW RD
SUMMERVILLE SC
29485-6206
US

V. Phone/Fax

Practice location:
  • Phone: 530-318-5651
  • Fax:
Mailing address:
  • Phone: 530-318-5651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC28800
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4210
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: