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112 John Street Suite 102 Easley SC 29640 | |
| (864) 442-7557 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 112 John Street, Easley, South Carolina |
| Authorized Official Name and Position | James Larry Pope (VICE PRESIDENT FINANCE) |
| Authorized Official Contact | 8644427610 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
112 John Street Suite 102 Easley SC 29640 Ph: (864) 442-7557 | 112 John Street Suite 102 Easley SC 29640 Ph: (864) 442-7557 |
| NPI Number | 1831426675 |
|---|---|
| Provider Enumeration Date | 11/16/2009 |
| Last Update Date | 11/16/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831426675 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (South Carolina) | Primary |
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