Healthcare Provider Details

I. General information

NPI: 1265344360
Provider Name (Legal Business Name): ENERGIZE HEALTH & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1171 MARKET ST STE 203
FORT MILL SC
29708-6503
US

IV. Provider business mailing address

1171 MARKET ST STE 203
FORT MILL SC
29708-6503
US

V. Phone/Fax

Practice location:
  • Phone: 803-548-5103
  • Fax: 803-548-5105
Mailing address:
  • Phone: 803-548-5103
  • Fax: 803-548-5105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DANNY CHARLES SMITH
Title or Position: OWNER/PHYSICIAN
Credential: DO
Phone: 803-982-0544