Organization
FOOTHILLS PEDIATRICS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FREDDA LEE MONROE (PRACTICE MANAGER)
(864) 220-1110
Entity
Organization
Contact information
Practice address
290 ENTERPRISE DR, EASLEY, SC 29642-8280
(864) 220-1110
(864) 220-1104
Mailing address
290 ENTERPRISE DR, EASLEY, SC 29642-8280
(864) 220-1110
(864) 220-1104
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3241
—
SC
Enumeration date
03/14/2006
Last updated
08/22/2020
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