# SURGERY & LASER CENTER AT PROFESSIONAL PARK LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Surgery & Laser Center at Professional Park LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477628725
- **Authorized official:** KEVIN BECKER (CFO)
- **Authorized official phone:** (914) 391-4921

## Contact information

- **Practice address:** 136 PROFESSIONAL PARK RD, CLINTON, SC 29325-7529
- **Practice address phone:** (864) 938-9836
- **Mailing address:** PO BOX 11407, BIRMINGHAM, AL 35246-8575
- **Mailing address phone:** (864) 359-1308
- **Mailing address fax:** (239) 496-3939

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | SC | Yes |

## Other

- **Enumeration date:** 11/22/2006
- **Last updated:** 04/28/2026