Organization
RELIFE PRO CORPORATION
Active
Other names
HealthSource of Indian Land, SC
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT PROVALENKO (OWNER)
(803) 992-9966
Entity
Organization
Contact information
Practice address
9716 REDSTONE DR, INDIAN LAND, SC 29707-5406
(803) 992-9966
Mailing address
9716 REDSTONE DR, INDIAN LAND, SC 29707-5406
(803) 992-9966
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
12/17/2024
Last updated
12/17/2024
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