Organization
SCX RAY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRISTIAN DE LA CRUZ (OWNER)
(843) 214-6683
Entity
Organization
Contact information
Practice address
104 BERKELEY SQUARE LANE PMB, #186, GOOSE CREEK, SC 29445
(843) 214-6683
Mailing address
104 BERKELEY SQUARE LANE PMB, #186, GOOSE CREEK, SC 29445
(843) 214-6683
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
12/10/2008
Last updated
12/10/2008
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