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General NPI Number Information
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NPI Number | 1881686947
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Entity Type | Individual
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Provider Name | ANDREW S. JETER DC
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Gender | Male
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Dates
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Enumeration Date | 08/16/2005
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Last Update Date | 10/29/2010
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Provider Practice Location Address
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Address Line | 1000 N MAIN ST
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City | SALISBURY
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State | NC
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Zip | 28144-3612
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Country | US
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Telephone | 704-633-5156
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Fax |
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Provider Business Mailing Address
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Address Line | 68 GLOBAL DR SUITE 100
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City | GREENVILLE
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State | SC
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Zip | 29607-4628
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Country | US
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Telephone | 864-644-2700
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Fax | 864-644-2709
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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 | 2045
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License Number State | NC
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