MEDICARE: DR. ANDREW JOSEPH KASIC D.C.

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
1	111N00000X	Chiropractor	2504	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194728386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW JOSEPH KASIC D.C.

Provider Business Mailing Address
First Line	:	1430 EBENEZER RD
Second Line	:	STE 101
City	:	ROCK HILL
State	:	SC
Zip	:	29732
Country	:	US
Telephone Number	:	803-366-8600
Fax Number	:	803-366-8877

Provider Business Practice Location Address
First Line	:	1430 EBENEZER RD
Second Line	:	SUITE 101
City	:	ROCK HILL
State	:	SC
Zip	:	29732
Country	:	US
Telephone Number	:	803-366-8600
Fax Number	:	803-366-8877

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	10/07/2010

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