Organization · Type 2 NPI
Active Life, LLC
Primary Care Clinic/Center · Charleston, SC
NPI number
1245549096
Active
Practice location
125 Wappoo Creek Dr, Suite 202
Charleston, SC 29412-2163
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Clinic/Center Primary | 261QP2300X | 3574 (SC) |
Primary Care Clinic/Center: Definition to come...
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About NPI 1245549096
Active Life, LLC's National Provider Identifier is 1245549096, issued on Sep 28, 2010. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Charleston, SC. The record was last updated on Sep 28, 2010.