Active Life, Llc | |
125 Wappoo Creek Dr Suite 202 Charleston SC 29412-2163 | |
(843) 588-5133 | |
Not Available |
Full Name | Active Life, Llc |
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Speciality | Clinic/center - Primary Care |
Location | 125 Wappoo Creek Dr, Charleston, South Carolina |
Authorized Official Name and Position | Kelly Erin O'neill (DOCTOR/OWNER) |
Authorized Official Contact | 8435885133 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Active Life, Llc 125 Wappoo Creek Dr Suite 202 Charleston SC 29412-2163 Ph: (843) 588-5133 | Active Life, Llc 125 Wappoo Creek Dr Suite 202 Charleston SC 29412-2163 Ph: (843) 588-5133 |
NPI Number | 1245549096 |
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Provider Enumeration Date | 09/28/2010 |
Last Update Date | 09/28/2010 |
Identifier | Type | State | Issuer |
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1245549096 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | 3574 (South Carolina) | Primary |
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