Healthcare Provider Details

I. General information

NPI: 1417878745
Provider Name (Legal Business Name): QUINTESSENCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 LEINBACH DR STE D2
CHARLESTON SC
29407-7086
US

IV. Provider business mailing address

29 LEINBACH DR STE D2
CHARLESTON SC
29407-7086
US

V. Phone/Fax

Practice location:
  • Phone: 843-284-9825
  • Fax:
Mailing address:
  • Phone: 843-284-9825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER SHIERLOCK
Title or Position: OWNER
Credential: MD
Phone: 843-284-9825