Intercostal Nonsurgical Diagnostic INC

NPI #1407397227 in Williamston, South Carolina

Provider Information

NPI Number: 1407397227
Entity Type: Organization
Organization Name: Intercostal Nonsurgical Diagnostic INC
Primary Specialty: Prevention Professional
Enumeration Date: Mar 13, 2017
Last Updated: Mar 13, 2017

Practice Location

Address: 24 E MAIN ST
City: Williamston
State: South Carolina
ZIP Code: 29697-1925
Phone: (864) 847-6020

Authorized Official

Name: JACK WISE, DC
Title: OWNER
Phone: (864) 847-6020

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Prevention Professional	405300000X	Primary

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