Organization
SOUTH CAROLINA CENTER FOR INTERGRATIVE MEDICINE
Active
Other names
South Carolina Center for Intergrative Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY SHIRK PAC (PHYSCIAN ASSISTANT)
(803) 386-8684
Entity
Organization
Contact information
Practice address
612 ST ANDREWS RD., STE 2, COLUMBIA, SC 29210-2921
(803) 386-8684
(803) 386-8684
Mailing address
612 SAINT ANDREWS RD STE 2, COLUMBIA, SC 29210-5120
(803) 386-8684
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2504
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164683926
COMMERCIAL
SC
Enumeration date
09/25/2017
Last updated
06/16/2018
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