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1325 Spring St Greenwood SC 29646-3860 | |
| (864) 725-4398 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1325 Spring St, Greenwood, South Carolina |
| Authorized Official Name and Position | Matthew T Logan (PRESIDENT AND CEO) |
| Authorized Official Contact | 8647254253 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1325 Spring St Greenwood SC 29646-3860 Ph: (864) 725-4398 | 1325 Spring St Greenwood SC 29646-3860 Ph: (864) 725-4398 |
| NPI Number | 1205253820 |
|---|---|
| Provider Enumeration Date | 03/20/2014 |
| Last Update Date | 12/14/2021 |
| Certification Date | 12/14/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205253820 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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