South Carolina Provider Services, LLC
NPI #1003413469 in Clemson, South Carolina
Provider Information
- NPI Number
- 1003413469
- Entity Type
- Organization
- Organization Name
- South Carolina Provider Services, LLC
- Primary Specialty
- Nurse Practitioner - Adult Health
- Enumeration Date
- Oct 7, 2020
- Last Updated
- May 5, 2021
Practice Location
- Address
- 500 DOWNS LOOP
- City
- Clemson
- State
- South Carolina
- ZIP Code
- 29631-2035
- Phone
- (864) 650-7475
Authorized Official
- Name
- JASON WILLIS
- Title
- COO
- Phone
- (864) 202-7415
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Adult Health — Adult Health |
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