# ENVISION WELLNESS MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831511989
- **Authorized official:** MS. ASHLEY FELDER (OFFICE MANAGER)
- **Authorized official phone:** (803) 256-0101

## Contact information

- **Practice address:** 2601 READ ST, SUITE I-7, COLUMBIA, SC 29204-7861
- **Practice address phone:** (803) 256-0101
- **Practice address fax:** (800) 854-3497
- **Mailing address:** 2601 READ ST, SUITE I-7, COLUMBIA, SC 29204-7861
- **Mailing address phone:** (803) 256-0101
- **Mailing address fax:** (800) 854-3497

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | 22943 | SC | Yes |

## Other

- **Enumeration date:** 01/08/2014
- **Last updated:** 01/08/2014