MEDICARE: CHARLESTON FAMILY CHIROPRACTIC

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

General Provider Information

NPI Number	:	1386299618
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARLESTON FAMILY CHIROPRACTIC

Provider Business Mailing Address
First Line	:	1418 MACCORKLE AVE SW STE A1
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25303-1342
Country	:	US
Telephone Number	:	304-344-9077
Fax Number	:	304-344-3587

Provider Business Practice Location Address
First Line	:	1418 MACCORKLE AVE SW STE A1
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25303-1342
Country	:	US
Telephone Number	:	304-344-9077
Fax Number	:	304-344-3587

Authorized Official
Title or Position	:	OWNER
Name	:	JARRED T NEWHOUSE
Credential	:	DC
Telephone Number	:	304-344-3582

Provider Enumeration Date	:	08/05/2019
Last Update Date	:	01/27/2025

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Directions to “CHARLESTON FAMILY CHIROPRACTIC ” Practice Location

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