MEDICARE: SIZEMORE CHIROPRACTIC AND REHABILITATION

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	3993	SC

General Provider Information

NPI Number	:	1740653856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIZEMORE CHIROPRACTIC AND REHABILITATION

Provider Business Mailing Address
First Line	:	1267 EBENEZER RD
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-2353
Country	:	US
Telephone Number	:	803-322-2297
Fax Number	:

Provider Business Practice Location Address
First Line	:	1267 EBENEZER RD
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-2353
Country	:	US
Telephone Number	:	803-322-2297
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LESLIE SUZANNE SIZEMORE
Credential	:	D.C.
Telephone Number	:	803-230-0045

Provider Enumeration Date	:	11/11/2015
Last Update Date	:	11/11/2015

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