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303 W Pine St Suite B Blacksburg SC 29702-1549 | |
(864) 839-3082 | |
(864) 839-3064 |
Full Name | |
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Speciality | Family Medicine |
Location | 303 W Pine St, Blacksburg, South Carolina |
Authorized Official Name and Position | Geoffrey K. Gardner (VP OF FINANCE) |
Authorized Official Contact | 7043849094 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 60447 Charlotte NC 28260-0447 Ph: (864) 487-0155 | 303 W Pine St Suite B Blacksburg SC 29702-1549 Ph: (864) 839-3082 |
NPI Number | 1912154501 |
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Provider Enumeration Date | 08/26/2008 |
Last Update Date | 05/31/2013 |
Identifier | Type | State | Issuer |
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1912154501 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |