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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
Colonial Life Health Resource Center
Organization subpart
No
Provider details
NPI number
Authorized official
JON LEIZMAN MD (PRESIDENT)
(216) 479-9063
Entity
Organization
Contact information
Practice address
1200 COLONIAL LIFE BLVD W, COLUMBIA, SC 29210-7670
(803) 213-6775
(803) 678-2138
Mailing address
5500 MARYLAND WAY, SUITE 400, BRENTWOOD, TN 37027-7048
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
12/20/2016
Last updated
08/23/2022
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