Wade D Reynolds Do, Llc

NPI 1518217389 - Clinic/Center - 261QP2300X

NPI Details
NPI 1518217389
Enumeration Date 09/19/2012
Last Updated 09/19/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name WADE WADE
Position PRESIDENT
Phone (803) 785-4555
Fax (803) 785-4556
Practice Location
111 IVY PARK LN
SUITE C
LEXINGTON SC, 29072-8289, US
Phone (803) 785-4555
Fax (803) 785-4556
Business Location
111 IVY PARK LANE
SUITE C
LEXINGTON SC, 29072-8289, US
Phone (803) 785-4555
Fax (803) 785-4556
Toxanomy
Taxonomy Code 261QP2300X
License State South Carolina
License Number 0417
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According to our database, Wade D Reynolds Do, Llc NPI is 1518217389, taxonomy code is 261QP2300X and license number is 0417, license state is located at South Carolina. Wade D Reynolds Do, Llc physically located at 111 Ivy Park Ln, Lexington SC, 29072-8289. NPI Number 1033115704 has the healthcare provider type.

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1518217389 NPI number is provided on an as is basis without warranty of any kind. 1518217389 is maintained by the National Plan & Provider Enumeration System. The contents of Wade D Reynolds Do, Llc are for informational purposes only.