| |
107 E North 1st St, Seneca, SC 29678-3240 | |
(864) 985-0808 | |
(864) 985-0525 |
Full Name | |
---|---|
Type | Facility |
Speciality | Podiatrist |
Location | 107 E North 1st St, Seneca, South Carolina |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1679840953 | NPI | - | NPPES |
PD1082 | Medicaid | SC | |
GP9988 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | 108 (South Carolina) | Primary |
Mailing Address | Practice Location Address |
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107 E North 1st St, Seneca, SC 29678-3240 Ph: (864) 985-0808 | 107 E North 1st St, Seneca, SC 29678-3240 Ph: (864) 985-0808 |