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Organization
UPSTATE PODIATRY GROUP, PA
Active
Organization
UPSTATE PODIATRY GROUP, PA
Active
Parent organization
UPSTATE PODIATRY GROUP, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
UPSTATE PODIATRY GROUP, PA
Authorized official
STEPHANIE RIDDLE (CFO)
(864) 979-3635
Entity
Organization
Contact information
Practice address
1420 JOHN B WHITE SR BLVD, SPARTANBURG, SC 29306-3927
(864) 399-9070
Mailing address
801 SE MAIN ST, SIMPSONVILLE, SC 29681-7150
(864) 399-9070
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
04/11/2022
Last updated
04/13/2022
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