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1942836754
SOUTHERN GRACE PAIN & REGENERATIVE MEDICINE
MOUNT PLEASANT, SC
NPI
1942836754
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Entity Type
Organization
Authorized Contact
WILLIAM BLANE BLANE RICHARDSON
Provider/Owner
843-754-4231
Organization Subpart ?
No
Primary Taxonomy
261QP3300X Clinic/Center, Pain
Enumeration Date
2020-03-13
Last Update Date
2020-03-13
Business Address
SOUTHERN GRACE PAIN & REGENERATIVE MEDICINE
3520 PARK AVENUE BLVD., SUITE 105
MOUNT PLEASANT, SC 29466
Phone number: 843-754-4231
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Mailing Address
SOUTHERN GRACE PAIN & REGENERATIVE MEDICINE
2256 BECKENHAM DR
MT PLEASANT, SC 29466-9009
Phone number: 843-754-4231
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