Organization
CAROL NICHOLS & CAROL KOOISTRA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE ANNETTE BROWN (FRONT OFFICE/ BILLING)
(864) 585-6179
Entity
Organization
Contact information
Practice address
541 FLOYD RD, SPARTANBURG, SC 29307-1520
(864) 585-6179
Mailing address
541 FLOYD RD, SPARTANBURG, SC 29307-1520
(864) 585-6179
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GPO487
—
SC
Enumeration date
10/10/2006
Last updated
11/16/2010
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