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General NPI Number Information
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NPI Number | 1063360675
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Entity Type | Organization
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Legal Business Name | ACACIA CHIROPRACTIC CLINIC PLLC
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Dates
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Enumeration Date | 03/19/2026
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Last Update Date | 03/19/2026
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Provider Practice Location Address
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Address Line | 1188 STONECREST BLVD STE 102
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City | FORT MILL
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State | SC
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Zip | 29708-6633
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Country | US
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Telephone | 803-412-2240
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Fax | 803-802-2413
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Provider Business Mailing Address
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Address Line | 10017 GLENCREST DR
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-5258
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Country | US
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Telephone | 803-412-2240
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Fax | 803-802-2413
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Authorized Official
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Title or Position | OWNER
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Name | JARED SAMS
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Credential |
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Telephone | 803-412-2240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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