Organization
WACCAMAW ENDOSCOPY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURENCE H BALLOU M.D. (MEDICAL DIRECTOR)
(843) 527-3428
Entity
Organization
Contact information
Practice address
2361 NORTH FRASER STREET, GEORGETOWN, SC 29440
(843) 527-3428
Mailing address
1011 N FRASER ST, GEORGETOWN, SC 29440-2848
(843) 527-3428
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
02/13/2007
Last updated
01/02/2008
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