Organization
PROFESSIONAL INTENSIVE OUTPATIENT PROGRAM OF FLORENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN GARY MARTIN M.ED, LPC, LPCS (LICENSED PROFESSIONAL COUNSELOR)
(843) 673-0054
Entity
Organization
Contact information
Practice address
323 S MCQUEEN ST, FLORENCE, SC 29501-4722
(843) 673-0054
(843) 667-1549
Mailing address
323 S MCQUEEN ST, FLORENCE, SC 29501-4722
(843) 673-0054
(843) 667-1549
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
326
SC
Other
Enumeration date
02/09/2007
Last updated
06/27/2008
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