Organization
CAROLINA CHILDREN'S CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID 'CARSON' MOORE (OWNER/AUTHORIZED OFFICIAL)
(843) 324-7575
Entity
Organization
Contact information
Practice address
316 VILLAGE CREEK DR, BOILING SPRINGS, SC 29316-5387
(864) 327-9003
Mailing address
316 VILLAGE CREEK DR, BOILING SPRINGS, SC 29316-5387
(864) 327-9003
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
—
—
208000000X
Pediatrics Physician
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
04/28/2022
Last updated
01/30/2023
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