Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2019-01-22
- Last updated
- 2019-01-22
Licenses
The registry row did not include a license.
Location
- Practice location
- 205 W MARION ST
- City
- KERSHAW SC
- Postal code
- 290671412
- Phone
- 803-438-5537
Organization contact
- Name
- WILLIAM MILES
- Title
- CFO
- Phone
- 8433356762
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.