Organization
ENVISION WELLNESS MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AYANNA SWINTON JAMISON MD (DR/OWNER)
(803) 256-0101
Entity
Organization
Contact information
Practice address
4100 N MAIN ST STE 101, COLUMBIA, SC 29203-5800
(803) 256-0101
(800) 854-3497
Mailing address
4100 N MAIN ST STE 101, COLUMBIA, SC 29203-5800
(803) 256-0101
(800) 854-3497
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Enumeration date
05/12/2020
Last updated
05/12/2020
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