Organization
STONE PLAZA @ MALLARD ST.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH ROGERS RPH (OWNER)
(864) 271-3544
Entity
Organization
Contact information
Practice address
124 MALLARD ST, GREENVILLE, SC 29601-4046
(864) 271-3544
(864) 271-3483
Mailing address
124 MALLARD ST, GREENVILLE, SC 29601-4046
(864) 271-3544
(864) 271-3483
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
09/08/2011
Last updated
09/08/2011
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