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Organization

UPSTATE AFFILIATE ORGANIZATION

Active
Other names
GHS Kidnetics - Spartanburg
Organization subpart
No

Provider details

NPI number
Authorized official
SPENCE M TAYLOR MD (EXECUTIVE - CORPORATE)
(864) 797-6118
Entity
Organization

Contact information

Practice address
249 N GROVE MEDICAL PARK DR, #300, SPARTANBURG, SC 29303-4227
(864) 598-0420
(864) 598-0431
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6307

Taxonomy

Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
HTL-0936
SC

Other

Enumeration date
03/01/2017
Last updated
03/01/2017
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