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General NPI Number Information
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NPI Number | 1902284631
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Entity Type | Organization
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Legal Business Name | INFINITE WELLNESS OF ROCK HILL LLC
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Dates
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Enumeration Date | 05/14/2015
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Last Update Date | 08/20/2015
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Provider Practice Location Address
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Address Line | 739 GALLERIA BLVD SUITE 112
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City | ROCK HILL
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State | SC
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Zip | 29730-7818
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Country | US
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Telephone | 803-547-4343
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Fax | 803-547-3914
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Provider Business Mailing Address
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Address Line | 739 GALLERIA BLVD SUITE 112
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City | ROCK HILL
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State | SC
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Zip | 29730-7818
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Country | US
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Telephone | 803-547-4343
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Fax | 803-547-3914
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. RICHARD S SCHAFFER JR.
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Credential | MD
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Telephone | 803-547-4343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD26568
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License Number State | SC
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