# THE SOUTHEASTERN SPINE INSTITUTE AMBULATORY SURGERY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033373691
- **Authorized official:** COLLIN LEMASTRIE (OFFICER / AUTHORIZED OFFICIAL)
- **Authorized official phone:** (469) 250-3640

## Contact information

- **Practice address:** 1625 HOSPITAL DRIVE, SUITE 110, MT. PLEASANT, SC 29464
- **Practice address phone:** (843) 849-1551
- **Practice address fax:** (843) 884-1174
- **Mailing address:** 1625 HOSPITAL DR STE 110, MT PLEASANT, SC 29464-3892
- **Mailing address phone:** (843) 849-1551
- **Mailing address fax:** (843) 884-1745

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/14/2008
- **Last updated:** 10/29/2024