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1295515765
MINDLAB LLC
NORTH MYRTLE BEACH, SC
NPI
1295515765
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Entity Type
Organization
Authorized Contact
STACEY SHAW
Pmhnp/Partner
843-321-5099
Organization Subpart ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
Enumeration Date
2023-10-03
Last Update Date
2023-10-03
Business Address
MINDLAB LLC
2423 HIGHWAY 17 S
NORTH MYRTLE BEACH, SC 29582-4343
Phone number: 843-321-5099
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Mailing Address
MINDLAB LLC
2423 HIGHWAY 17 S
NORTH MYRTLE BEACH, SC 29582-4343
Phone number: 843-321-5099
Copy
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