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General NPI Number Information
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NPI Number | 1164489332
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Entity Type | Individual
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Provider Name | JESSICA A CARDINAL DC
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Gender | Female
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Dates
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Enumeration Date | 04/29/2006
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Last Update Date | 03/16/2018
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Provider Practice Location Address
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Address Line | 7522 IRMO DR STE 1
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City | COLUMBIA
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State | SC
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Zip | 29212-8640
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Country | US
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Telephone | 803-454-1096
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Fax | 803-454-1095
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Provider Business Mailing Address
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Address Line | PO BOX 1322
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City | IRMO
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State | SC
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Zip | 29063-1322
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Country | US
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Telephone | 803-454-1096
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Fax | 803-454-1095
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2340
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License Number State | SC
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