is a Primary Podiatric Medicine in Greenville, South Carolina. practices all healthcare services and medical treatments related to Primary Podiatric Medicine. The NPI Number for is 1487811337. The last update date is .
's current location address is 11 Mills Ave, Greenville, South Carolina. You can contact this provider via phone number 8642323668 and fax number 8642710526. The mailing address for is 11 Mills Ave, Greenville, South Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 11 Mills Ave, Greenville, South Carolina |
| Phone Number | 8642323668 |
| Fax Number | 8642710526 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1487811337 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 11 Mills Ave |
|---|---|
| City | Greenville |
| State | South Carolina (SC) |
| Post Code | 296054015 |
| Phone Number | 8642323668 |
| Fax Number | 8642710526 |
Provider's Primary Taxonomy Detail
| Speciality | Primary Podiatric Medicine |
|---|---|
| Taxonomy | 213Ep1101X |
| Licence No | 632 |
|
Definition: A doctor of podiatric medicine expert in general podiatry health services related to medical diagnoses and treatment of the foot, ankle and lower extremities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| SC183006626 | SC | PTAN |
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