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1275963175
GREENVILLE AGE MANAGEMENT MEDICAL INSTITUTE, LLC
GREENVILLE, SC
NPI
1275963175
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Entity Type
Organization
Authorized Contact
MARCELA YOUNG
Owner
864-365-0100
Organization Subpart ?
No
Primary Taxonomy
261QP2300X Clinic/Center, Primary Care
(Licence: SC 14183)
Enumeration Date
2013-11-14
Last Update Date
2013-11-14
Business Address
GREENVILLE AGE MANAGEMENT MEDICAL INSTITUTE, LLC
540 OLD HOWELL RD
GREENVILLE, SC 29615-1969
Phone number: 864-365-0100
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Mailing Address
GREENVILLE AGE MANAGEMENT MEDICAL INSTITUTE, LLC
540 OLD HOWELL RD
GREENVILLE, SC 29615-1969
Phone number:
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