Organization
FAJAS OF COLUMBIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS SULTON CNA (OWNER)
(803) 602-5570
Entity
Organization
Contact information
Practice address
7201 TWO NOTCH RD STE AL120, COLUMBIA, SC 29223-1319
(803) 602-5570
Mailing address
7201 TWO NOTCH RD STE AL120, COLUMBIA, SC 29223-1319
(803) 602-5570
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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