| |
45 Roundtree St Williston SC 29853-2303 | |
(803) 266-3600 | |
Not Available |
Full Name | |
---|---|
Speciality | Clinic/center - Primary Care |
Location | 45 Roundtree St, Williston, South Carolina |
Authorized Official Name and Position | Mary T Valliant (CEO) |
Authorized Official Contact | 8032591000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
45 Roundtree St Williston SC 29853-2303 Ph: (803) 266-3600 | 45 Roundtree St Williston SC 29853-2303 Ph: (803) 266-3600 |
NPI Number | 1730588211 |
---|---|
Provider Enumeration Date | 08/20/2014 |
Last Update Date | 08/20/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1730588211 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | HTL0485 (South Carolina) | Primary |