Organization
RADDON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER N PHILLIPS (MANAGER)
(770) 335-9797
Entity
Organization
Contact information
Practice address
114 GATEWAY CORPORATE BLVD STE 220, COLUMBIA, SC 29203-9785
(770) 335-9797
(803) 849-8247
Mailing address
114 GATEWAY CORPORATE BLVD STE 220, COLUMBIA, SC 29203-9785
(770) 335-9797
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/18/2018
Last updated
06/23/2022
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