# COMMUNITY CHIROPRACTIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962644179
- **Authorized official:** DR. KEVIN MILES MOBLEY D.C. (OWNER)
- **Authorized official phone:** (864) 859-7900

## Contact information

- **Practice address:** 1097 S PENDLETON ST, EASLEY, SC 29642-1050
- **Practice address phone:** (864) 859-7900
- **Practice address fax:** (864) 859-7999
- **Mailing address:** 1097 S PENDLETON ST, EASLEY, SC 29642-1050
- **Mailing address phone:** (864) 859-7900
- **Mailing address fax:** (864) 859-7999

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 3368 | SC | Yes |

## Other

- **Enumeration date:** 04/02/2009
- **Last updated:** 04/02/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1205909009 | INDIVIDUAL NPI | SC |
| 01 | — | AA32600281 | MEDICARE PTAN | SC |
| 01 | — | P00641082 | MEDICARE RAILROAD PTAN | — |