Organization
GREENVILLE NEUROLOGY CONSULTANTS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GENNA MARIE LYNN CMOM (OFFICE MANAGER)
(864) 242-9662
Entity
Organization
Contact information
Practice address
4 OLD GROVE RD, GREENVILLE, SC 29605-4712
(864) 242-9662
(864) 467-0980
Mailing address
4 OLD GROVE RD, GREENVILLE, SC 29605-4712
(864) 242-9662
(864) 467-0980
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
17836
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1244
—
SC
05
—
Q29590
—
SC
Enumeration date
09/14/2006
Last updated
03/23/2010
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