Intercostal Nonsurgical Diagnostic Inc

Organization Active NPI Prevention Professional · Williamston, SC

NPI 1407397227 · NPPES record last updated Mar 13, 2017

Key facts

NPI
1407397227
Entity type
Organization (NPI type 2)
Primary specialty
Prevention Professional 405300000X
Legal business name
INTERCOSTAL NONSURGICAL DIAGNOSTIC INC
Practice address
24 E Main St
Williamston, SC 29697-1925
Phone
(864) 847-6020
Fax
(864) 840-9668
NPI assigned
Mar 13, 2017
Organization subpart
No

Authorized official

Name
Jack Wise, DC
Title
Owner
Phone
(864) 847-6020

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Prevention Professional
Group: 193400000X SINGLE SPECIALTY GROUP
405300000X Yes

Addresses

Primary practice location

24 E Main St
Williamston, SC 29697-1925

Mailing address

24 E Main St
Williamston, SC 29697-1925
Phone (864) 847-6020

Other providers in Williamston, SC

All providers in Williamston, SC · Prevention Professional in South Carolina

Sources for this page

Verify at the official NPI Registry.