Organization
PAIN INSTITUTE OF CHARLESTON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN PARKS GARDNER MD (OWNER)
(843) 805-2628
Entity
Organization
Contact information
Practice address
1014 SAINT ANDREWS BLVD STE 210A, CHARLESTON, SC 29407-7177
(843) 805-2628
Mailing address
353 ASHLEY AVE, CHARLESTON, SC 29403-4684
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
04/16/2021
Last updated
01/07/2022
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