Organization
UPSTATE PODIATRY GROUP, PA
Active
Parent organization
UPSTATE PODIATRY GROUP, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
UPSTATE PODIATRY GROUP, PA
Authorized official
STEPHANIE THOMAS (PRACTICE ADMINISTRATOR)
(864) 399-9070
Entity
Organization
Contact information
Practice address
1012 MEDICAL RIDGE RD, CLINTON, SC 29325-4542
(864) 833-9274
Mailing address
801 SE MAIN ST, SIMPSONVILLE, SC 29681-7150
(864) 399-9070
(864) 399-9664
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/08/2018
Last updated
04/08/2020
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