Organization
IASIS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETTY JEAN LAWRENCE (OWNER)
(843) 902-4863
Entity
Organization
Contact information
Practice address
514 ALDER ST, SUITE 6, MYRTLE BEACH, SC 29577-3854
(843) 902-4863
Mailing address
514 ALDER ST, SUITE 6, MYRTLE BEACH, SC 29577-3854
(843) 902-4863
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MAS . 8158
—
Other
Enumeration date
10/09/2012
Last updated
10/09/2012
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