Individual provider · Type 1 NPI
Tyler A. Jack, DC
Chiropractor · Spartanburg, SC
NPI number
1386080653
Active
Practice location
445 S Blackstock Rd
Spartanburg, SC 29301-3646
Fax (864) 804-6595
Mailing address
PO Box 170956
Spartanburg, SC 29301-0035
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor Primary | 111N00000X | 3828 (SC) |
Chiropractor: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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About NPI 1386080653
Tyler A. Jack, DC's National Provider Identifier is 1386080653, issued on May 14, 2013. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in Spartanburg, SC. The record was last updated on Jul 14, 2014.