Active Life, LLC
NPI #1245549096 in Charleston, South Carolina
Provider Information
- NPI Number
- 1245549096
- Entity Type
- Organization
- Organization Name
- Active Life, LLC
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Sep 28, 2010
- Last Updated
- Sep 28, 2010
Practice Location
- Address
- 125 WAPPOO CREEK DR
- Address 2
- SUITE 202
- City
- Charleston
- State
- South Carolina
- ZIP Code
- 29412-2163
- Phone
- (843) 588-5133
Authorized Official
- Name
- DR. KELLY ERIN O'NEILL, D.C.
- Title
- DOCTOR/OWNER
- Phone
- (843) 588-5133
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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