Organization
PREMISE HEALTH OF SOUTH CAROLINA MEDICAL, P.C
Active
Other names
Adidas SPG Health Center DC2
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN LEIZMAN MD (DIRECTOR)
(216) 479-9063
Entity
Organization
Contact information
Practice address
670 FALLING CREEK RD, SPARTANBURG, SC 29301-1063
(615) 468-3188
Mailing address
5500 MARYLAND WAY STE 120, BRENTWOOD, TN 37027-4993
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
06/15/2022
Last updated
08/23/2022
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