MEDICARE: SOUTH CAROLINA ACUPUNCTURE WELLNESS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1699577247
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH CAROLINA ACUPUNCTURE WELLNESS, LLC

Provider Business Mailing Address
First Line	:	1622 E NORTH ST STE 3
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29607-1329
Country	:	US
Telephone Number	:	864-516-6868
Fax Number	:

Provider Business Practice Location Address
First Line	:	1622 E NORTH ST STE 3
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29607-1329
Country	:	US
Telephone Number	:	551-587-2287
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GRACE ZUCCARO MINNELLA
Credential	:	DAC
Telephone Number	:	551-587-2287

Provider Enumeration Date	:	03/25/2025
Last Update Date	:	03/25/2025

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