Individual
MR. MARCO ANTONIO DIAZ III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1400 CLEVELAND ST, GREENVILLE, SC 29607-2410
(864) 467-3790
Mailing address
10 DORA ST, PELZER, SC 29669-1602
(864) 905-8291
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/15/2013
Last updated
01/15/2013
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