Provider Demographics
NPI:1841518735
Name:NAZARENKO, ERIC MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:MICHAEL
Last Name:NAZARENKO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 E MAIN ST STE L2
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-3670
Mailing Address - Country:US
Mailing Address - Phone:803-808-0711
Mailing Address - Fax:803-808-0713
Practice Address - Street 1:711 E MAIN ST STE L2
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-3670
Practice Address - Country:US
Practice Address - Phone:803-808-0711
Practice Address - Fax:803-808-0713
Is Sole Proprietor?:No
Enumeration Date:2010-05-17
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3572111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor