Colonial Family Practice - Manning
NPI #1689006652 in Manning, South Carolina
Provider Information
- NPI Number
- 1689006652
- Entity Type
- Organization
- Organization Name
- Colonial Family Practice - Manning
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- COLONIAL FAMILY PRACTICE, LLC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Aug 1, 2013
- Last Updated
- Mar 22, 2021
Practice Location
- Address
- 1036 PROFESSIONAL CT
- City
- Manning
- State
- South Carolina
- ZIP Code
- 29102-2827
- Phone
- (803) 773-5227
Authorized Official
- Name
- MRS. STEPHANIE KNIGHT DISHER
- Title
- CREDENTIALING MANAGER
- Phone
- (803) 773-5227
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
| Physician Assistant |
| Physician Assistant - Medical — Medical |
| Nurse Practitioner - Family — Family |
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