Organization Name: | MSN MANAGEMENT, LLC |
NPI Number: | 1083003941 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LORETTA RICARD NOLES (PARTNER) |
Mailing Address: | 1 Wellness Blvd Suite 111 Irmo |
State: | SC US |
Postal Code: | 290632871 |
Phone Number: | 8039171684 |
Fax Number: | |
NPI Enumeration Date: | 01/15/2015 |
NPI Last Update Date: | 01/31/2015 |
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: |