Healthcare Provider Details

I. General information

NPI: 1477090256
Provider Name (Legal Business Name): MEGHAN COLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2017
Last Update Date: 01/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 SUMTER ST
COLUMBIA SC
29201-2501
US

IV. Provider business mailing address

PO BOX 2521
COLUMBIA SC
29202-2521
US

V. Phone/Fax

Practice location:
  • Phone: 803-806-8889
  • Fax: 803-806-8893
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberTL277
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: