Organization
SANDHILLS FOOT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL THACKER DPM (SOLE MEMBER)
(803) 788-6400
Entity
Organization
Contact information
Practice address
1821 CLEMSON RD, COLUMBIA, SC 29229-7832
(803) 788-6400
Mailing address
1821 CLEMSON RD, COLUMBIA, SC 29229-7832
(803) 788-6400
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
00627
SC
Other
Enumeration date
01/25/2016
Last updated
01/25/2016
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