Mustang Medicine Works, Llc | |
25 Iselin St Liberty SC 29657-1508 | |
(864) 508-0781 | |
(206) 309-0077 |
Full Name | Mustang Medicine Works, Llc |
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Speciality | Counselor - Professional |
Location | 25 Iselin St, Liberty, South Carolina |
Authorized Official Name and Position | Darrell Gene Yardley (C.EO.) |
Authorized Official Contact | 8645080781 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Mustang Medicine Works, Llc Po Box 702 Liberty SC 29657-1508 Ph: (864) 508-0781 | Mustang Medicine Works, Llc 25 Iselin St Liberty SC 29657-1508 Ph: (864) 508-0781 |
NPI Number | 1396127056 |
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Provider Enumeration Date | 06/18/2015 |
Last Update Date | 06/18/2015 |
Identifier | Type | State | Issuer |
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1396127056 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 2584 (South Carolina) | Primary |
Mustang Medicine Works, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5642 Moorefield Memorial Hwy., Liberty, SC 29657 Phone: 864-508-0781 |