Organization
REAGAN MEDICAL CONSULTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHAIRIYA C BRYANT (CREDENTIALING CONSULTANT)
(850) 339-1359
Entity
Organization
Contact information
Practice address
7107 BOWEN CORNER AVE, HANAHAN, SC 29410-4813
(864) 346-3957
Mailing address
1000 CLYBURN PL, AIKEN, SC 29801-4193
(864) 346-3957
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
169882
—
SC
Enumeration date
04/09/2021
Last updated
04/09/2021
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