Organization
AIKEN PROFESSIONAL ASSOCIATION, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD EVANS (VP)
(610) 382-4334
Entity
Organization
Contact information
Practice address
420 SOCIETY HILL DR, SUITE 200, AIKEN, SC 29803-1731
(803) 649-7266
(803) 649-7158
Mailing address
420 SOCIETY HILL DR, SUITE 200, AIKEN, SC 29803-1731
(803) 649-7266
(803) 649-7158
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
1639
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016397
—
SC
Enumeration date
07/14/2015
Last updated
06/26/2019
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