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Organization

CAROLINA PODIATRY GROUP, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BRANDON SCOT PERCIVAL DPM (OWNER)
(803) 285-1411
Entity
Organization

Contact information

Practice address
1190 HIGHWAY 9 BYP W, LANCASTER, SC 29720-1709
(803) 285-1411
(803) 283-9920
Mailing address
PO BOX 325, LANCASTER, SC 29721-0325
(803) 285-1411
(803) 283-9920

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
DE1510
SC
Enumeration date
01/24/2008
Last updated
01/24/2008
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