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Organization
CAROLINA PHYSICAL MEDICINE AND
Active
Organization
CAROLINA PHYSICAL MEDICINE AND
Active
Other names
CORE Health Centers-East Spartanburg
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE C WADDELL CPC (BILLING MANAGER)
(864) 469-2045
Entity
Organization
Contact information
Practice address
958 E MAIN ST, SUITE A, SPARTANBURG, SC 29302-2148
(864) 542-0780
(864) 542-1689
Mailing address
958 E MAIN ST, SUITE A, SPARTANBURG, SC 29302-2148
(864) 542-0780
(864) 542-1689
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
207Q00000X
Family Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
193200000X
TAXONOMY CODE
SC
Enumeration date
03/15/2010
Last updated
06/16/2015
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