Organization
KAOF SPORTS THERAPEUTIC GUIDANCE GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELISSA L KENYON (OFFICER)
(803) 526-6665
Entity
Organization
Contact information
Practice address
2000 FOREST RIDGE DR, FORT MILL, SC 29715-6432
(803) 526-6665
Mailing address
2000 FOREST RIDGE DR, FORT MILL, SC 29715-6432
(803) 526-6665
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/08/2019
Last updated
08/08/2019
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