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Organization
CAROLINA LONG TERM CARE ASSOICATES,PC
Active
Organization
CAROLINA LONG TERM CARE ASSOICATES,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH BRYAN HELLER MD (PRESIDENT)
(864) 940-9701
Entity
Organization
Contact information
Practice address
113 WILDWOOD DR, BELTON, SC 29627-9687
(864) 940-9701
(864) 338-8760
Mailing address
PO BOX 846, BELTON, SC 29627-0846
(864) 940-9701
(864) 338-8760
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3289
—
SC
Enumeration date
07/06/2006
Last updated
09/16/2010
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