Organization Name: | REAL HEALTH CLINIC LLC |
NPI Number: | 1801218169 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RENEE HUNTER (OWNER) |
Mailing Address: | 101 Springhall Dr Goose Creek |
State: | SC US |
Postal Code: | 294455336 |
Phone Number: | 8433020920 |
Fax Number: | 8433020925 |
NPI Enumeration Date: | 01/06/2014 |
NPI Last Update Date: | 07/31/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 0349 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |