Organization
LOOKING GLASS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN C ELLYN M.D. (PRESIDENT)
(843) 577-6506
Entity
Organization
Contact information
Practice address
31 SMITH ST, CHARLESTON, SC 29401-1720
(843) 723-4854
(843) 723-9835
Mailing address
31 SMITH ST, CHARLESTON, SC 29401-1720
(843) 723-4854
(843) 723-9835
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
SC
Other
Enumeration date
04/04/2007
Last updated
03/10/2008
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