Healthcare Provider Details

I. General information

NPI: 1396146858
Provider Name (Legal Business Name): AFFORDABLE ALLERGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2014
Last Update Date: 09/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W COLEMAN BLVD SUITE 101
MOUNT PLEASANT SC
29464-3429
US

IV. Provider business mailing address

300 W COLEMAN BLVD SUITE 101
MOUNT PLEASANT SC
29464-3429
US

V. Phone/Fax

Practice location:
  • Phone: 843-754-2020
  • Fax:
Mailing address:
  • Phone: 843-754-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State

VIII. Authorized Official

Name: ELLEN LITTLE
Title or Position: PRACTICE MANAGER
Credential:
Phone: 843-754-2020