Organization
ANGEL OAK FAMILY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE LEONARA BAER FNPC (PROVIDER)
(843) 559-1938
Entity
Organization
Contact information
Practice address
1816 BOHICKET RD STE F, JOHNS ISLAND, SC 29455-3318
(843) 559-1938
Mailing address
PO BOX 336, JOHNS ISLAND, SC 29457-0336
(843) 559-1938
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
RHC153
SC
Other
Enumeration date
01/30/2008
Last updated
12/06/2012
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