MEDICARE: DR. JESSICA HARDEN-VENABLE 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	4290	NC
2	111N00000X	Chiropractor	3730	SC

General Provider Information

NPI Number	:	1922354034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA HARDEN-VENABLE D.C.

Provider Business Mailing Address
First Line	:	3071 HIGHWAY 21 BYP
Second Line	:	STE 103
City	:	FORT MILL
State	:	SC
Zip	:	29715-7205
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3071 HIGHWAY 21 BYP
Second Line	:	STE 103
City	:	FORT MILL
State	:	SC
Zip	:	29715-7205
Country	:	US
Telephone Number	:	704-907-2757
Fax Number	:

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

Provider Enumeration Date	:	07/25/2012
Last Update Date	:	11/07/2023

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