Organization
LAKE CITY MEDICAL ASSOCIATES 2017, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHEILA P GODWIN (OFFICE MANAGER)
(843) 374-3277
Entity
Organization
Contact information
Practice address
130 S ACLINE ST, LAKE CITY, SC 29560-2633
(843) 374-3277
(843) 374-3281
Mailing address
130 S ACLINE ST, LAKE CITY, SC 29560-2633
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/15/2017
Last updated
03/02/2018
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