Organization
CORE INTERNATIONAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA GARDNER (OFFICE MANAGER)
(803) 779-7500
Entity
Organization
Contact information
Practice address
1415 BLANDING ST STE 4, COLUMBIA, SC 29201-2922
(803) 779-7500
Mailing address
1415 BLANDING ST STE 4, COLUMBIA, SC 29201-2922
(803) 779-7500
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/29/2021
Last updated
09/29/2021
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