| Organization Name: | THE SOUTHEASTERN SPINE INSTITUTE AMBULATORY SURGERY CENTER, LLC |
| NPI Number: | 1033373691 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOESPH O FISCHER (CHIEF EXECUTIVE OFFICIER) |
| Mailing Address: | 1106 Chuck Dawley Blvd Suite 100 Mt Pleasant |
| State: | SC US |
| Postal Code: | 294644183 |
| Phone Number: | 8438491551 |
| Fax Number: | 8438496591 |
| NPI Enumeration Date: | 07/14/2008 |
| NPI Last Update Date: | 07/16/2008 |
| 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: | |