MEDICARE: DR. JAY MARTIN SCHWARTZ 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	2062	SC

General Provider Information

NPI Number	:	1619904075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAY MARTIN SCHWARTZ D.C.

Provider Business Mailing Address
First Line	:	187 6TH AVE
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-2805
Country	:	US
Telephone Number	:	843-303-5551
Fax Number	:	843-747-4421

Provider Business Practice Location Address
First Line	:	5122 N RHETT AVE
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29405-4240
Country	:	US
Telephone Number	:	843-744-2265
Fax Number	:	843-747-4421

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	07/08/2007

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