Organization
LIVING WELL CENTERS PRIMARY CARE AND BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DWAYNE POPE (CEO)
(843) 812-5988
Entity
Organization
Contact information
Practice address
101 RICE BENT WAY, SUITE 2, COLUMBIA, SC 29229-6849
(803) 667-9312
(803) 667-9313
Mailing address
101 RICE BENT WAY, SUITE 2, COLUMBIA, SC 29229-6849
(803) 667-9312
(803) 667-9313
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/21/2011
Last updated
11/21/2011
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