Organization
SOUTHERN GRACE PAIN & REGENERATIVE MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM BLANE BLANE RICHARDSON MD (PROVIDER/OWNER)
(843) 754-4231
Entity
Organization
Contact information
Practice address
3520 PARK AVENUE BLVD., SUITE 105, MOUNT PLEASANT, SC 29466
(843) 754-4231
Mailing address
2256 BECKENHAM DR, MT PLEASANT, SC 29466-9009
(843) 754-4231
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Enumeration date
03/13/2020
Last updated
03/13/2020
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