Upstate Carolina Medical LLC
NPI #1457002123 in Clemson, South Carolina
Provider Information
- NPI Number
- 1457002123
- Entity Type
- Organization
- Organization Name
- Upstate Carolina Medical LLC
- Primary Specialty
- Nurse Practitioner
- Enumeration Date
- Jan 14, 2022
- Last Updated
- Jun 1, 2022
Practice Location
- Address
- 144 THOMAS GREEN BLVD STE 232
- City
- Clemson
- State
- South Carolina
- ZIP Code
- 29631-2291
- Phone
- (864) 722-5203
Authorized Official
- Name
- JESSICA VASSALLO
- Title
- OWNER/ NURSE PRACTITIONER
- Phone
- (864) 903-9604
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner |
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