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NPI Code Detail

MEDICARE: ACACIA CHIROPRACTIC CLINIC PLLC

MEDICARE: ACACIA CHIROPRACTIC CLINIC PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor

General Provider Information

NPI Number : 1063360675
Entity Type Code : Organization
Provider Name (Legal Business Name) : ACACIA CHIROPRACTIC CLINIC PLLC
Provider Business Mailing Address
First Line : 10017 GLENCREST DR
Second Line :
City : HUNTERSVILLE
State : NC
Zip : 28078-5258
Country : US
Telephone Number : 803-412-2240
Fax Number : 803-802-2413
Provider Business Practice Location Address
First Line : 1188 STONECREST BLVD STE 102
Second Line :
City : FORT MILL
State : SC
Zip : 29708-6633
Country : US
Telephone Number : 803-412-2240
Fax Number : 803-802-2413
Authorized Official
Title or Position : OWNER
Name : JARED SAMS
Credential :
Telephone Number : 803-412-2240
Provider Enumeration Date : 03/19/2026
Last Update Date : 03/19/2026

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