Organization
FLORENCE PODIATRY ASSOCIATES, LLC
Active
Parent organization
FLORENCE PODIATRY ASSOCIATES, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FLORENCE PODIATRY ASSOCIATES, LLC
Authorized official
DR. DWAYNE A. JACOBUS DPM (OWNER)
(843) 679-9090
Entity
Organization
Contact information
Practice address
492 W CHEVES ST, FLORENCE, SC 29501-4447
(843) 679-9090
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
04/02/2012
Last updated
04/02/2012
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