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General NPI Number Information
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NPI Number | 1306501127
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Entity Type | Organization
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Legal Business Name | ADVANTAGE FOOT CARE OF SOUTH CAROLINA LLC
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Dates
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Enumeration Date | 11/05/2021
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 6824 M W RICKENBAKER RD
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City | SUMMERTON
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State | SC
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Zip | 29148-8709
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Country | US
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Telephone | 803-460-3080
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Fax |
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Provider Business Mailing Address
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Address Line | 104 BERKELEY SQUARE LN # 135
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City | GOOSE CREEK
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State | SC
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Zip | 29445-2958
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Country | US
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Telephone | 803-460-3080
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HELEN D GIPSON
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Credential | DPM
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Telephone | 214-404-5215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number |
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License Number State |
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