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Organization

UPSTATE MEDICAL REHABILITATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DEBBIE J UNDERWOOD (BUSINESS ADMINISTRATOR)
(864) 232-8417
Entity
Organization

Contact information

Practice address
1003 GROVE RD, SUITE E, GREENVILLE, SC 29605-4626
(864) 232-8417
(864) 232-1511
Mailing address
1003 GROVE RD, SUITE E, GREENVILLE, SC 29605-4626
(864) 232-8417
(864) 232-1511

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1013980168
NPI
SC
01
1396799763
NPI
SC
01
1659325934
NPI
SC
01
1699727008
NPI
SC
01
1962466276
NPI
SC
01
20810000X
TAXONOMY
SC
05
GP1248
SC
05
GP2707
SC
Enumeration date
12/12/2006
Last updated
12/12/2007
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