Organization
SOUTHERN CHARM MEDICAL AND WELLNESS, LLC
Active
Parent organization
CRYSTAL B. CLARK
Other names
Southern Charm Health & Wellness Center, LLC, Southern Charm Medical & Wellness, Southern Charm Medical & Wellness, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CRYSTAL B. CLARK
Authorized official
CRYSTAL B CLARK FNP-C (OWNER/PROVIDER)
(843) 675-5070
Entity
Organization
Contact information
Practice address
211 S PEARL ST STE B, PAGELAND, SC 29728-2261
(843) 675-5070
(989) 214-7326
Mailing address
211 S PEARL ST STE B, PAGELAND, SC 29728-2261
(843) 675-5070
(989) 214-7326
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22378
SC APRN
SC
01
—
22N33N45
CSL
SC
Enumeration date
03/25/2024
Last updated
03/08/2026
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