Colonial Family Practice, LLC
NPI #1508302308 in Manning, South Carolina
Provider Information
- NPI Number
- 1508302308
- Entity Type
- Organization
- Organization Name
- Colonial Family Practice, LLC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Jan 17, 2017
- Last Updated
- Jan 17, 2017
Practice Location
- Address
- 1013 PROFESSIONAL CT
- Address 2
- SUITE C
- City
- Manning
- State
- South Carolina
- ZIP Code
- 29102-2827
- Phone
- (803) 433-7444
Authorized Official
- Name
- BRAD MCINTOSH
- Title
- OFFICE MANAGER
- Phone
- (803) 433-7444
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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