| NPI | 1568207702 |
|---|---|
| Other Name | CRESCENT MEDICAL FOOT SPA |
| Entity Type | Organization |
| Authorized Contact | KIMBERLY DIANNE BILLIE JACKSON Co Owner 803-580-4747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QX0100X Clinic/Center Occupational Medicine |
| Additional Taxonomies | 163WA0400X Registered Nurse Addiction (Substance Use Disorder) |
| 163WW0000X Registered Nurse Wound Care | |
| 2083A0300X Preventive Medicine Addiction Medicine | |
| 261QC1500X Clinic/Center Community Health | |
| 363L00000X Nurse Practitioner | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| 363LP2300X Nurse Practitioner Primary Care | |
| 363LX0106X Nurse Practitioner Occupational Health | |
| Enumeration Date | 2024-06-28 |
| Last Update Date | 2024-08-27 |