Facts
- Status
- A
- Type
- Individual
- Enumeration date
- 2026-05-08
- Last updated
- 2026-05-11
Specialties
Licenses
- License SC
- 209822
Location
- Practice location
- 231 MCADAMS SCHOOL RD
- City
- HONEA PATH SC
- Postal code
- 296549591
- Phone
- 864-940-8242
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.