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) | Code | License | State | Primary |
|---|---|---|---|---|
| Prevention Professional |
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
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- Kristi Forrest King
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- Giovanna Loren Magliulo
All providers in Williamston, SC · Prevention Professional in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.