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Individual

DR. TYLER A JACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
445 S BLACKSTOCK RD, SPARTANBURG, SC 29301-3646
(864) 804-6395
(864) 804-6595
Mailing address
PO BOX 170956, SPARTANBURG, SC 29301-0035
(864) 804-6395
(864) 804-6595

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3828
SC

Other

Enumeration date
05/14/2013
Last updated
07/14/2014
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