Organization
FOOT CLINIC OF SOUTH CAROLINA, LLC
Active
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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