Organization
GREENVILLE AGE MANAGEMENT MEDICAL INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCELA YOUNG M.D. (OWNER)
(864) 365-0100
Entity
Organization
Contact information
Practice address
540 OLD HOWELL RD, GREENVILLE, SC 29615-1969
(864) 365-0100
Mailing address
540 OLD HOWELL RD, GREENVILLE, SC 29615-1969
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
14183
SC
Other
Enumeration date
11/14/2013
Last updated
11/14/2013
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