Organization
FAMILY WELLNESS CENTER OF CHARLESTON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STANIA A DEJESUS DO (OWNER)
(843) 729-8269
Entity
Organization
Contact information
Practice address
9217 UNIVERSITY BLVD, C1B, NORTH CHARLESTON, SC 29406-9147
(843) 729-8269
Mailing address
9217 UNIVERSITY BLVD, C1B, NORTH CHARLESTON, SC 29406-9147
(843) 729-8269
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
1175
SC
Other
Enumeration date
01/27/2015
Last updated
01/27/2015
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