Organization
LAKELANDS ORTHOPAEDIC CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN F POORE (ACCOUNTANT BILLING MANAGER)
(864) 323-0527
Entity
Organization
Contact information
Practice address
102 GREGOR MENDEL CIR, GREENWOOD, SC 29646-2315
(864) 229-2663
(864) 223-5694
Mailing address
PO BOX 848287, BOSTON, MA 02284-8287
(864) 229-2663
(864) 223-5694
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0378
—
SC
Enumeration date
10/03/2006
Last updated
09/18/2008
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