Healthcare Provider Details

I. General information

NPI: 1366869190
Provider Name (Legal Business Name): WINNING HEALTH WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2014
Last Update Date: 03/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

966 HOUSTON NORTHCUTT BLVD
MOUNT PLEASANT SC
29464-3487
US

IV. Provider business mailing address

966 HOUSTON NORTHCUTT BLVD
MOUNT PLEASANT SC
29464-3487
US

V. Phone/Fax

Practice location:
  • Phone: 843-471-0375
  • Fax:
Mailing address:
  • Phone: 843-471-0375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW J MCMARLIN
Title or Position: D.O
Credential:
Phone: 843-471-0375