| Organization Name: | SYNERGY SPINE CENTER, PA |
| NPI Number: | 1013996750 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARION R MCMILLAN (MEDICAL DIRECTOR OWNER) |
| Mailing Address: | 457d By Pass 123 Seneca |
| State: | SC US |
| Postal Code: | 29678 |
| Phone Number: | 8648828850 |
| Fax Number: | 8648820420 |
| NPI Enumeration Date: | 01/11/2006 |
| NPI Last Update Date: | 03/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |