Individual
ADRIENNE LOUISE LABOTKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
406 MEMORIAL DRIVE EXT, GREER, SC 29651-1818
(864) 877-9066
(864) 848-3291
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23633
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00423931
MEDICARE RAILROAD PTAN
GA
05
—
T79420
—
SC
Enumeration date
05/22/2006
Last updated
10/02/2013
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