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General NPI Number Information
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NPI Number | 1982138715
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Entity Type | Organization
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Legal Business Name | SKIN SOLUTION TO MASSAGE
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Dates
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Enumeration Date | 04/19/2017
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Last Update Date | 04/19/2017
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Provider Practice Location Address
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Address Line | 1 CHICK SPRINGS RD STE 207A
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City | GREENVILLE
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State | SC
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Zip | 29609-4976
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Country | US
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Telephone | 843-952-3199
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Fax |
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Provider Business Mailing Address
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Address Line | 1 CHICK SPRINGS RD STE 207A
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City | GREENVILLE
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State | SC
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Zip | 29609-4976
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Country | US
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Telephone | 843-952-3199
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Fax |
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Authorized Official
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Title or Position | ONWER
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Name | MR. CORY WILLIAMS
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Credential |
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Telephone | 843-952-3199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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