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Organization
SC MC SPROUT LLC
Active
Organization
SC MC SPROUT LLC
Active
Other names
Elemy, Sprout Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN SELZER (CHIEF FINANCIAL OFFICER)
(833) 384-7193
Entity
Organization
Contact information
Practice address
331 E MAIN ST STE 200, ROCK HILL, SC 29730-5384
(833) 991-2368
(929) 384-7193
Mailing address
331 E MAIN ST STE 200, ROCK HILL, SC 29730-5384
(833) 991-2368
(929) 384-7193
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/21/2021
Last updated
09/27/2021
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