Organization
MIDLANDS ELECTRODIAGNOSTIC SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER L GRAY (OFFICE MANAGER)
(803) 401-1372
Entity
Organization
Contact information
Practice address
421 HULON LN, WEST COLUMBIA, SC 29169-4832
(803) 739-1315
Mailing address
296 SHERINGHAM RD, COLUMBIA, SC 29212-8679
(803) 401-1372
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
05/30/2007
Last updated
08/22/2020
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