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Organization

STRAND REGIONAL SPECIALTY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SONJA WILLIS (INSURANCE SPECIALIST)
(843) 692-2149
Entity
Organization

Contact information

Practice address
8170 ROURK ST, MYRTLE BEACH, SC 29572-4127
(843) 449-2336
(843) 497-2505
Mailing address
PO BOX 70399, MYRTLE BEACH, SC 29572-0025
(843) 449-2336
(843) 497-2505

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
261QR0200X
Radiology Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1819815
PA
01
5599938
GHI
NY
05
790167K
NC
05
GP1523
SC
Enumeration date
03/20/2006
Last updated
07/21/2010
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