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Organization

CAROLINA FACE AND BODY

Active
Other names
Southern Grace Plastic Surgery
Organization subpart
No

Provider details

NPI number
Authorized official
KAYLA HUMENANSKY DO (CHIEF MEDICAL OFFICER)
(803) 212-5288
Entity
Organization

Contact information

Practice address
927 CHAPIN RD, CHAPIN, SC 29036-8875
(803) 212-5288
Mailing address
1174 PUTNAM DR, CHAPIN, SC 29036-9785
(803) 212-5288

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary

Other

Enumeration date
12/04/2025
Last updated
12/04/2025
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