Organization
TEEN HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANICE E RICHARDS (OFFICE MANAGER)
(803) 366-9119
Entity
Organization
Contact information
Practice address
725 CHERRY RD, SUITE 104, ROCK HILL, SC 29732-3150
(803) 366-9119
(803) 366-9389
Mailing address
725 CHERRY RD, SUITE 104, ROCK HILL, SC 29732-3150
(803) 366-9119
(803) 366-9389
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
77686
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3274
—
SC
Enumeration date
12/22/2005
Last updated
08/22/2020
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