Organization
ELITE ORTHOPAEDICS OF SOUTH CAROLINA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JENEANE MARIE WAKULA (OFFICE MANAGER)
(772) 546-9591
Entity
Organization
Contact information
Practice address
235 SINGLETON RIDGE RD, CONWAY, SC 29526-9136
(843) 347-4357
Mailing address
235 SINGLETON RIDGE RD, CONWAY, SC 29526-9136
(843) 347-4357
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
TL37747
SC
Other
Enumeration date
11/01/2015
Last updated
11/01/2015
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