Healthcare Provider Details

I. General information

NPI: 1629202239
Provider Name (Legal Business Name): LOWCOUNTRY BALANCE & HEARING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2009
Last Update Date: 05/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

874 ORLEANS RD SUITE 1
CHARLESTON SC
29407-4857
US

IV. Provider business mailing address

874 ORLEANS RD SUITE 1
CHARLESTON SC
29407-4857
US

V. Phone/Fax

Practice location:
  • Phone: 843-819-7455
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number3421
License Number StateSC

VIII. Authorized Official

Name: DR. JOHN EVERETT KING III
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 843-819-7455