Southern Grace Pain & Regenerative Medicine

NPI #1942836754 in Mount Pleasant, South Carolina

Provider Information

NPI Number
1942836754
Entity Type
Organization
Organization Name
Southern Grace Pain & Regenerative Medicine
Primary Specialty
Clinic/Center - Pain
Enumeration Date
Mar 13, 2020
Last Updated
Mar 13, 2020

Practice Location

Address
3520 PARK AVENUE BLVD., SUITE 105
ZIP Code
29466
Phone
(843) 754-4231

Authorized Official

Name
DR. WILLIAM BLANE BLANE RICHARDSON, MD
Title
PROVIDER/OWNER
Phone
(843) 754-4231

Specialties & Taxonomy Codes

Specialty
Clinic/Center - PainPain

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