Organization
LYMPHEDEMA AND REHAB CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JEANNE NOURSE OTR (OWNER AND DIRECTOR)
(864) 934-0423
Entity
Organization
Contact information
Practice address
1701 N MAIN ST, ANDERSON, SC 29621-4761
(864) 934-0423
(864) 226-3015
Mailing address
PO BOX 42, ANDERSON, SC 29622-0042
(864) 934-0423
(864) 226-3015
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0558
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023175601
INDIVIDUAL
SC
Enumeration date
07/05/2007
Last updated
08/22/2020
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