Organization
PREMISE HEALTH OF SOUTH CAROLINA MEDICAL, P.C
Active
Other names
DTNA Occ - Gaffney
Organization subpart
No
Provider details
NPI number
Authorized official
JON LEIZMAN (PRESIDENT)
(216) 479-9063
Entity
Organization
Contact information
Practice address
211 WOODLAND RD, GAFFNEY, SC 29341-1055
(864) 301-8325
(864) 489-1949
Mailing address
5500 MARYLAND WAY, BRENTWOOD, TN 37027-7048
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
08/17/2021
Last updated
08/23/2022
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