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Organization
PROVIDENCE ORTHOPAEDIC GROUP, LLC
Active
Organization
PROVIDENCE ORTHOPAEDIC GROUP, LLC
Active
Other names
Moore Orthopaedic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
SEAN MCNALLY (CEO)
(803) 227-8152
Entity
Organization
Contact information
Practice address
114 GATEWAY CORPORATE BLVD, SUITE 100, COLUMBIA, SC 29203-9740
(803) 227-8000
Mailing address
PO BOX 9592, BELFAST, ME 04915-9592
(803) 227-8000
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
10/07/2010
Last updated
06/02/2011
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