PROVIDENCE FAMILY PRACTICE LLC

Family Medicine Physician

NPI: 1528066115Organization

Specialties, Licenses & Credentials

Family Medicine PhysicianPrimary

Family Medicine

Code: 207Q00000X

13507(SC)21987(SC)8387(SC)

Contact & Hours

Address: 2750 LAUREL ST, 103
COLUMBIA, SC 29204
Phone: (803) 254-5171

Quick Facts

NPI: 1528066115
Entity Type: Organization
Medicare: Not confirmed
Specialties: 3
Locations: 1

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