Organization
THE MEDICAL PLACE FAMILY PRACTICE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TASHA MATTHEWS BOONE M.D. (PRESIDENT)
(803) 358-9843
Entity
Organization
Contact information
Practice address
3020 SUNSET BLVD, SUITE 101, WEST COLUMBIA, SC 29169-3493
(803) 791-5680
Mailing address
212 CHERRY GROVE DR, WEST COLUMBIA, SC 29170-3070
(803) 358-9843
(803) 358-9843
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
24923
SC
Other
Enumeration date
10/06/2008
Last updated
10/06/2008
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