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Organization
CP&L
Active
Organization
CP&L
Active
Other names
Atlantic Spine and Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQUELINE FAGIOLI (OFFICE MANAGER)
(843) 884-1876
Entity
Organization
Contact information
Practice address
1150 HUNGRYNECK BLVD STE D, MOUNT PLEASANT, SC 29464-3484
(843) 884-1876
Mailing address
1150 HUNGRYNECK BLVD STE D, MOUNT PLEASANT, SC 29464-3484
(843) 884-1876
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
10/06/2020
Last updated
01/07/2021
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