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Organization
PREMISE HEALTH OF SOUTH CAROLINA MEDICAL, P.C
Active
Organization
PREMISE HEALTH OF SOUTH CAROLINA MEDICAL, P.C
Active
Other names
Adidas SPG Health Center DC1
Organization subpart
No
Provider details
NPI number
Authorized official
JON LEIZMAN MD (DIRECTOR)
(216) 479-9063
Entity
Organization
Contact information
Practice address
495 CEDAR CREST RD, SPARTANBURG, SC 29301-5101
(615) 468-3188
Mailing address
5500 MARYLAND WAY STE 120, BRENTWOOD, TN 37027-4993
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
06/10/2022
Last updated
08/23/2022
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