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General NPI Number Information
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NPI Number | 1699339168
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Entity Type | Organization
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Legal Business Name | PALMETTO EARLY INTERVENTION SERVICE
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Dates
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Enumeration Date | 04/30/2019
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Last Update Date | 04/30/2019
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Provider Practice Location Address
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Address Line | 350 CEDAR SPRINGS RD
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City | SPARTANBURG
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State | SC
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Zip | 29302-4637
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Country | US
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Telephone | 864-237-8112
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Fax | 864-751-6389
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Provider Business Mailing Address
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Address Line | 124 BAY TREE CT
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City | INMAN
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State | SC
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Zip | 29349-5923
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Country | US
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Telephone | 864-237-8112
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Fax | 864-751-6389
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | VICTORIA PHILLIPS
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Credential |
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Telephone | 864-237-8112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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