Organization
WELSCARE OF SOUTH CAROLINA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD LILJENQUIST (OWNER)
(801) 420-2516
Entity
Organization
Contact information
Practice address
111 LOVETT DR, GREENVILLE, SC 29607-6510
(801) 869-4100
(208) 869-4119
Mailing address
1250 E 3900 S STE 440, SALT LAKE CITY, UT 84124-1349
(801) 869-4100
(801) 869-4119
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/28/2023
Last updated
09/10/2024
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