MEDICARE: UNITED 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	:	1588874267
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED CHIROPRACTIC

Provider Business Mailing Address
First Line	:	3705 RENEE DR
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-4109
Country	:	US
Telephone Number	:	843-903-3507
Fax Number	:	843-903-0687

Provider Business Practice Location Address
First Line	:	3705 RENEE DR
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-4109
Country	:	US
Telephone Number	:	843-903-3507
Fax Number	:	843-903-0687

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JACK SCOTT
Credential	:	D.C.
Telephone Number	:	843-903-3507

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	05/12/2009

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Directions to “UNITED CHIROPRACTIC ” Practice Location

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