Organization
ASY ABSOLUTE WELLNESS CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER YOUNG M.E.D (PARTNER/STAFF)
(803) 335-1272
Entity
Organization
Contact information
Practice address
2712 MIDDLEBURG DR, SUITE 206, COLUMBIA, SC 29204-2415
(803) 335-1272
(803) 335-1272
Mailing address
2712 MIDDLEBURG DR, SUITE 206, COLUMBIA, SC 29204-2415
(803) 335-1272
(803) 335-1272
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
GP5785
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
22943
SC
291U00000X
Clinical Medical Laboratory
42D2033880
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP5785
—
SC
Enumeration date
07/11/2011
Last updated
06/18/2013
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