Organization
WELLNESSONE ANCILLARY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARIN GREEN (MANAGER)
(843) 444-9355
Entity
Organization
Contact information
Practice address
4736A HIGHWAY 17 BYP S, MYRTLE BEACH, SC 29588-5616
(843) 444-9355
Mailing address
4736A HIGHWAY 17 BYP S, MYRTLE BEACH, SC 29588-5616
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
02/11/2013
Last updated
04/09/2013
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