Organization
SOUTH CAROLINA PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC
Active
Other names
Piedmont Podiatry Assoc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON PERCIVAL D.P.M. (PRESIDENT)
(803) 285-1411
Entity
Organization
Contact information
Practice address
11 MILLS AVE, GREENVILLE, SC 29605-4015
(864) 232-3668
(864) 271-0526
Mailing address
8141 ROURK STREET, MYRTLE BEACH, SC 29572
(803) 285-1411
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
SC
Other
Enumeration date
02/26/2014
Last updated
06/24/2014
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