Organization
EAST COOPER PHYSICIAN GROUP LLC
Active
Organization
EAST COOPER PHYSICIAN GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
7 S ALLIANCE DR STE 111B, GOOSE CREEK, SC 29445-7296
(843) 971-9350
(843) 971-9351
Mailing address
PO BOX 604408, CHARLOTTE, NC 28260-4408
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
Other
Enumeration date
12/09/2025
Last updated
02/28/2026
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