Organization
SC-PREMIER WELLNESS CARE
Active
Other names
Premier Wellness Care
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUE SHADLE (CEO)
(225) 445-0038
Entity
Organization
Contact information
Practice address
400 PENDLETON RD, CLEMSON, SC 29631-2211
(225) 620-6222
(864) 722-5319
Mailing address
400 PENDLETON RD, CLEMSON, SC 29631-2211
(864) 722-5315
(864) 722-5319
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/24/2016
Last updated
06/01/2016
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