Organization
BEACHSIDE CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY C HORNICK (OWNER)
(842) 877-5224
Entity
Organization
Contact information
Practice address
931 MEDICAL CIR, MYRTLE BEACH, SC 29572-4122
(843) 877-5224
Mailing address
931 MEDICAL CIR, MYRTLE BEACH, SC 29572-4122
(843) 877-5224
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
11/21/2012
Last updated
11/21/2012
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