Greenville Functional Medicine

NPI 1033545595 - Clinic/Center - 261Q00000X

NPI Details
NPI 1033545595
Enumeration Date 09/16/2013
Last Updated 09/16/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name VICKIE VICKIE
Position TEAM LEADER
Phone (864) 558-0200
Fax (864) 520-1245
Practice Location
301 HALTON RD
SUITE A
GREENVILLE SC, 29607-3496, US
Phone (864) 558-0200
Fax (864) 520-1245
Business Location
301 HALTON RD
SUITE A
GREENVILLE SC, 29607-3496, US
Phone (864) 558-0200
Fax (864) 520-1245
Toxanomy
Taxonomy Code 261Q00000X
License State South Carolina
License Number 14652
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According to our database, Greenville Functional Medicine NPI is 1033545595, taxonomy code is 261Q00000X and license number is 14652, license state is located at South Carolina. Greenville Functional Medicine physically located at 301 Halton Rd, Greenville SC, 29607-3496. NPI Number 1033115704 has the healthcare provider type.

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1033545595 NPI number is provided on an as is basis without warranty of any kind. 1033545595 is maintained by the National Plan & Provider Enumeration System. The contents of Greenville Functional Medicine are for informational purposes only.