Organization
ENVISION WELLNESS MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ASHLEY FELDER (OFFICE MANAGER)
(803) 256-0101
Entity
Organization
Contact information
Practice address
2601 READ ST, SUITE I-7, COLUMBIA, SC 29204-7861
(803) 256-0101
(800) 854-3497
Mailing address
2601 READ ST, SUITE I-7, COLUMBIA, SC 29204-7861
(803) 256-0101
(800) 854-3497
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
22943
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
229434
—
SC
Enumeration date
01/08/2014
Last updated
01/08/2014
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