Organization
LAKE CAROLINA PAIN AND SPINE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAMRAN Z KORANLOO M.D. (PHYSICIAN)
(803) 764-1228
Entity
Organization
Contact information
Practice address
1821 CLEMSON RD, COLUMBIA, SC 29229-7832
(803) 788-5916
(803) 788-9564
Mailing address
1821 CLEMSON RD, COLUMBIA, SC 29229-7832
(803) 788-5916
(803) 788-9564
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
23150
SC
Other
Enumeration date
03/02/2015
Last updated
01/06/2020
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