Organization
LEJEUNE INTEGRATED MEDICAL CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE PRUSSO DC (CLINIC DIRECTOR)
(925) 766-8275
Entity
Organization
Contact information
Practice address
530 HAYWOOD RD, GREENVILLE, SC 29607-2711
(925) 766-8275
Mailing address
530 HAYWOOD RD, GREENVILLE, SC 29607-2711
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/21/2021
Last updated
05/11/2022
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