Organization
ACTIVE LIFE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY ERIN O'NEILL D.C. (DOCTOR/OWNER)
(843) 588-5133
Entity
Organization
Contact information
Practice address
125 WAPPOO CREEK DR, SUITE 202, CHARLESTON, SC 29412-2163
(843) 588-5133
Mailing address
125 WAPPOO CREEK DR, SUITE 202, CHARLESTON, SC 29412-2163
(843) 588-5133
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
3574
SC
Other
Enumeration date
09/28/2010
Last updated
09/28/2010
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