Dutch Fork Family Practice

NPI 1083761316 - Clinic/Center - 261QP2300X

NPI Details
NPI 1083761316
Enumeration Date 01/05/2007
Last Updated 08/07/2013
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name MICHELLE MICHELLE
Position OWNER
Phone (803) 732-8370
Fax (803) 732-8373
Practice Location
110 DUTCHMAN BLVD.
IRMO SC, 29063, US
Phone (803) 732-8370
Fax (803) 732-8373
Business Location
110 DUTCHMAN BLVD.
IRMO SC, 29063, US
Phone (803) 732-8370
Fax (803) 732-8373
Toxanomy
Taxonomy Code 261QP2300X
License State
License Number
Remove 1083761316 NPI Number
 

According to our database, Dutch Fork Family Practice NPI is 1083761316, taxonomy code is 261QP2300X Dutch Fork Family Practice physically located at 110 Dutchman Blvd., Irmo SC, 29063. NPI Number 1033115704 has the healthcare provider type.

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1083761316 NPI number is provided on an as is basis without warranty of any kind. 1083761316 is maintained by the National Plan & Provider Enumeration System. The contents of Dutch Fork Family Practice are for informational purposes only.