Healthcare Provider Details

I. General information

NPI: 1346900453
Provider Name (Legal Business Name): GENTLE STIX COLLECTION & TRAINING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2021
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8502 TWO NOTCH RD STE J-8
COLUMBIA SC
29223-6307
US

IV. Provider business mailing address

8502 TWO NOTCH RD STE J-8
COLUMBIA SC
29223-6307
US

V. Phone/Fax

Practice location:
  • Phone: 833-436-8531
  • Fax:
Mailing address:
  • Phone: 833-436-8531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: PIA CHELETTE SIMMONS
Title or Position: OWNER
Credential:
Phone: 803-476-7646