Healthcare Provider Details

I. General information

NPI: 1285643973
Provider Name (Legal Business Name): ANDERSON BONE AND JOINT CLINIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 MONTGOMERY DR
ANDERSON SC
29621-3334
US

IV. Provider business mailing address

112 MONTGOMERY DR
ANDERSON SC
29621-3334
US

V. Phone/Fax

Practice location:
  • Phone: 864-276-0056
  • Fax:
Mailing address:
  • Phone: 864-276-0056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: LINDA L HOWARD
Title or Position: OFFICE MANGER
Credential:
Phone: 864-276-0056