Organization
ISLAND SLEEP LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN FENNELL (MANAGING PARTNER)
(843) 842-9919
Entity
Organization
Contact information
Practice address
58 SHELTER COVE LANE, SUITE E1, HILTON HEAD ISLAND, SC 29928
(843) 842-9919
(843) 842-9963
Mailing address
58 SHELTER COVE LANE, SUITE E1, HILTON HEAD ISLAND, SC 29928
(843) 842-9919
(843) 842-9963
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PL0083
—
SC
Enumeration date
10/11/2006
Last updated
08/22/2020
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