Organization
LAKE RIDGE NEUROLOGICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ORLANDO ARTHUR RICALDE M.D. (PRESIDENT)
(864) 885-9866
Entity
Organization
Contact information
Practice address
SUITE B 103 OMNI DRIVE, SENECA, SC 29672-9448
(864) 885-9866
(864) 888-8307
Mailing address
SUITE B 103 OMNI DRIVE, SENECA, SC 29672-9448
(864) 885-9866
(864) 888-8307
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1724
—
SC
Enumeration date
02/14/2006
Last updated
10/10/2007
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