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General NPI Number Information
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NPI Number | 1801289772
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Entity Type | Organization
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Legal Business Name | GENTLE TOUCH LLC
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Dates
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Enumeration Date | 03/16/2015
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Last Update Date | 03/16/2015
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Provider Practice Location Address
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Address Line | 287 HIGHWAY 90 E STE 7
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City | LITTLE RIVER
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State | SC
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Zip | 29566-7214
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Country | US
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Telephone | 843-467-4319
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Fax | 843-249-4777
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Provider Business Mailing Address
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Address Line | PO BOX 1183
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City | LITTLE RIVER
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State | SC
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Zip | 29566-1183
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Country | US
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Telephone | 843-467-4319
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Fax | 843-249-4777
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Authorized Official
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Title or Position | OWNER
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Name | TANIEKA GAUSE
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Credential | PHLEBOTOMIST
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Telephone | 843-467-4319
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 201403
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License Number State | SC
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