Organization
FOOT CLINIC OF SOUTH CAROLINA, LLC
Active
Other names
Brad Lindstrom DPM
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY ALLEN LINDSTROM DPM (OWNER)
(864) 281-9171
Entity
Organization
Contact information
Practice address
211 E BUTLER RD, SUITE A2, MAULDIN, SC 29662-2169
(864) 281-9171
(978) 327-7938
Mailing address
211 E BUTLER RD, SUITE A-2, MAULDIN, SC 29662-2169
(864) 281-9171
(864) 281-9170
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
555
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
480033893
RAILROAD MEDICARE
SC
05
—
GP9936
—
SC
Enumeration date
01/29/2007
Last updated
01/31/2011
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