Organization · Type 2 NPI

Self Medical Group

Occupational Medicine Clinic/Center · Greenwood, SC

NPI number 1760808083 Active

Practice location

450 Old Brickyard Rd
Greenwood, SC 29649-8681

Call (864) 725-7491 Map

Mailing address

104 Wells Ave
Greenwood, SC 29646-3837

Specialties and licenses

Taxonomy	Code	License
Occupational Medicine Clinic/Center Primary	261QX0100X	None listed

Occupational Medicine Clinic/Center: Definition to come...

NPI record

NPI: 1760808083
Entity type: Organization (Type 2)
Issued: Mar 11, 2014
Last updated: Dec 14, 2021
Status: Active

Other names

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Light and Life Wellness Clinic · other name
Light and Life Wellness Clinic · other name

Authorized official

Dr. Matthew T Logan, MD
President and CEO
(864) 725-4253

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1760808083

Self Medical Group's National Provider Identifier is 1760808083, issued on Mar 11, 2014. The primary taxonomy on file is Occupational Medicine Clinic/Center (261QX0100X), and the practice location is in Greenwood, SC. The record was last updated on Dec 14, 2021.