DR. JACK D WISE JR. (NPI# 1255402905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255402905 |
| Entity Type | Individual |
| Full Name | DR. JACK D WISE JR. |
| Credential | DC |
| Practice Address |
24 East Main Street Williamston SC 29697 |
| Mailing Address |
24 East Main St Williamston SC 29697 |
| Practice Telephone | 8648476020 |
| Practice Fax Number | 8648476007 |
| Mailing Telephone | 8648476020 |
| Mailing Fax Number | 8648476007 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2007-11-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 1743 | SC | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | CH1743 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780040808 | Jack Wise | Chiropractor | 701 E Broward Blvd Ste D, Fort Lauderdale, FL 33301-2022 | 2016-01-05 |
| Street Address |
24 EAST MAIN STREET |
| City | WILLIAMSTON |
| State | SC |
| Zip Code | 29697 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760893705 | Daniel Alexander Ellis | Occupational Therapy Assistant | 801 N. Hamilton St., Williamston, SC 29697 | 2014-05-13 |
| 1093134108 | Luz Brown | Pharmacist | 102 Wood Stream Way, Williamston, SC 29697 | 2014-04-16 |
| 1144644410 | Lynne Phillips | Registered Nurse | 804 N. Hamilton Street, Williamston, SC 29697 | 2014-02-07 |
| 1396969556 | Ambucare Ambulance LLC. | Non-emergency Medical Transport (VAN) | 303 Beaverdam Road, Williamston, SC 29697 | 2007-04-12 |
| 1275676892 | Jorge Antonio Perdomo | Social Worker | 900 Greenville Drive, Williamston, SC 29697 | 2007-02-14 |
| 1245301985 | Complete Healing & Wellness Center P.a. | Chiropractor | 24 East Main St, Williamston, SC 29697 | 2006-11-13 |
| 1285839563 | Lou Wingo Rogers | Counselor | 900 Greenville Drive, Williamston, SC 29697 | 2007-06-18 |
| 1578634218 | Marylouise Schultz Wise | Chiropractor | 24 East Main St, Williamston, SC 29697 | 2006-11-13 |
| 1447654363 | New Dominion Community Services LLC | Counselor | 900 Greenville Drive, Williamston, SC 29697-0000 | 2014-10-21 |
| 1730504499 | Robin Crawford | Registered Nurse | 803 N Hamilton St, Williamston, SC 29697-1061 | 2014-03-04 |
| Find all providers in zip 29697 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720692924 | Scott Chiropractic LLC | Chiropractor | 1075 Walmart Dr, Williamston, NC 27892-9749 | 2020-09-04 |
| 1649796434 | Allyson Patricia Nash | Chiropractor | 1235 E Grand River Rd Ste 1a, Williamston, MI 48895-8303 | 2017-08-14 |
| 1295134559 | Williamston Wellness Pllc | Chiropractor | 1235 E Grand River Rd, Suite 1-a, Williamston, MI 48895-8303 | 2014-08-21 |
| 1780706705 | Jc Chiropractic LLC | Chiropractor | 17 Glenwood Ave, Williamston, SC 29697-1225 | 2007-04-03 |
| 1265588016 | Williamston Chiropractic Center | Chiropractor | 613 East Blvd, Williamston, NC 27892-2735 | 2007-01-26 |
| 1245301985 | Complete Healing & Wellness Center P.a. | Chiropractor | 24 East Main St, Williamston, SC 29697 | 2006-11-13 |
| 1609850924 | Robert M. Durham | Chiropractor | 900 Greenville Dr, Williamston, SC 29697-1130 | 2005-11-30 |
| 1659614501 | Williamston Sport and Spine Chiropractic Clinic | Chiropractor | 425 W Grand River Ave, Suite D, Williamston, MI 48895-1343 | 2013-03-28 |
| 1033386396 | Ann Marie Pushies D.c., P.C. | Chiropractor | 832 E Grand River Ave, Williamston, MI 48895-1538 | 2008-05-14 |
| 1184785156 | Ryan Michial Nielsen | Chiropractor | 309 W Main St, Williamston, NC 27892-2317 | 2006-12-13 |
| Find all providers in WILLIAMSTON | ||||
| City | WILLIAMSTON |
| Zip Code | 29697 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.