MEDICARE: CHIROSERV INC

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	:	1447658570
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROSERV INC

Provider Business Mailing Address
First Line	:	130 RIVER LANDING DR
Second Line	:	UNIT 12D
City	:	DANIEL ISLAND
State	:	SC
Zip	:	29492-7400
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	130 RIVER LANDING DR
Second Line	:	UNIT 12D
City	:	DANIEL ISLAND
State	:	SC
Zip	:	29492-7400
Country	:	US
Telephone Number	:	843-527-4200
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JIMMY SMITH
Credential	:
Telephone Number	:	843-527-4200

Provider Enumeration Date	:	12/05/2014
Last Update Date	:	12/05/2014

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Directions to “CHIROSERV INC ” Practice Location

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