Organization
UPSTATE PEDORTHIC SERVICES INC.
Active
Other names
UPSTATE PEDORTHIC SERICES
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALTER D BALLARD II C PED (OWNER)
(864) 848-3300
Entity
Organization
Contact information
Practice address
24 PARKWAY COMMONS WAY, GREER, SC 29650-5213
(864) 848-3300
(864) 848-2100
Mailing address
24 PARKWAY COMMONS WAY, GREER, SC 29650-5213
(864) 848-3300
(864) 848-2100
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7702097
—
NC
05
—
DE1002
—
SC
Enumeration date
06/21/2007
Last updated
07/18/2013
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