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1003928680
NORTHLAKE FAMILY MEDICAL PRACTICE
COLUMBIA, SC
NPI
1003928680
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Entity Type
Organization
Authorized Contact
REGINALD L PARKER
Owner
803-419-5131
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: SC 14862)
Enumeration Date
2006-08-31
Last Update Date
2007-10-16
Business Address
NORTHLAKE FAMILY MEDICAL PRACTICE
3000 NE MEDICAL PARK STE 101
COLUMBIA, SC 29223-6251
Phone number: 803-419-5131
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Mailing Address
NORTHLAKE FAMILY MEDICAL PRACTICE
3000 NE MEDICAL PARK STE 101
COLUMBIA, SC 29223-6251
Phone number: 803-419-5131
Copy
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