Organization
PALMETTO DYNAMICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES KELVIN JOHNSON (ADMINISTRATOR)
(803) 234-2216
Entity
Organization
Contact information
Practice address
4112 HARTFORD ST, COLUMBIA, SC 29204-3025
(803) 234-2216
(866) 263-6551
Mailing address
7001 SAINT ANDREWS RD, STE 319, COLUMBIA, SC 29212-1137
(803) 234-2216
(866) 263-6551
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/01/2009
Last updated
06/01/2009
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