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NPI Code Detail

MEDICARE: IMC OF SOUTH CAROLINA

MEDICARE: IMC OF SOUTH CAROLINA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1386073302
Entity Type Code : Organization
Provider Name (Legal Business Name) : IMC OF SOUTH CAROLINA
Provider Business Mailing Address
First Line : 2615 CENTENNIAL BLVD
Second Line : SUITE 101
City : TALLAHASSEE
State : FL
Zip : 32308-0586
Country : US
Telephone Number : 850-656-1837
Fax Number : 850-877-2917
Provider Business Practice Location Address
First Line : 2420 TWO NOTCH RD
Second Line :
City : LEXINGTON
State : SC
Zip : 29072-7963
Country : US
Telephone Number : 850-656-1837
Fax Number :
Authorized Official
Title or Position : INSURANCE & BILLING COORDINATOR
Name : MRS. TARA N. ATKINSON
Credential :
Telephone Number : 850-656-1837
Provider Enumeration Date : 11/12/2013
Last Update Date : 11/12/2013

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Directions to “IMC OF SOUTH CAROLINA ” Practice Location

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