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Organization

BIG FISH PHYSICAL MEDICINE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN ALEXANDER NICHOLSON M.D. (PRESIDENT)
(843) 971-3373
Entity
Organization

Contact information

Practice address
3400 SALTERBECK CT, SUITE 102, MOUNT PLEASANT, SC 29466-7118
(843) 971-3373
Mailing address
3400 SALTERBECK CT, SUITE 102, MOUNT PLEASANT, SC 29466-7118
(843) 971-3373

Taxonomy

Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
SC 15656
SC

Other

Enumeration date
07/05/2006
Last updated
03/10/2008
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