| |
514 S Dargan St Suite G Florence SC 29506-2552 | |
(843) 667-8561 | |
(843) 673-0206 |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 514 S Dargan St, Florence, South Carolina |
Authorized Official Name and Position | Jon H Docherty (OWNER) |
Authorized Official Contact | 8436678561 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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514 S Dargan St Suite G Florence SC 29506-2552 Ph: (843) 667-8561 | 514 S Dargan St Suite G Florence SC 29506-2552 Ph: (843) 667-8561 |
NPI Number | 1013957521 |
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Provider Enumeration Date | 06/07/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013957521 | NPI | - | NPPES |
077552 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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