Individual
DR. CHUCKY SENTELL JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
263 KELLEY ST STE 100, LAKE CITY, SC 29560-2472
(843) 394-8274
Mailing address
542 BEN GAUSE RD, COWARD, SC 29530-5127
(843) 940-0687
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
SC 4099
SC
Other
Enumeration date
01/11/2016
Last updated
01/11/2016
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