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Organization
SOUTH CAROLINA PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC
Active
Organization
SOUTH CAROLINA PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON PERCIVAL DPM (PRESIDENT)
(803) 285-1411
Entity
Organization
Contact information
Practice address
428 HYATT ST, STE A, GAFFNEY, SC 29341-2537
(864) 487-3338
(864) 487-4102
Mailing address
8141 ROURK ST, MYRTLE BEACH, SC 29572-4128
(803) 285-1411
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
564
SC
Other
Enumeration date
02/20/2014
Last updated
05/08/2014
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