NPI 1255790499
Providence Physician Practices, LLC
Practice location
- Address
- 2750 Laurel St Suite 104, Columbia, SC 29204-2038
- Phone
- (803) 799-9035
- Mailing address
- 330 Seven Springs Way, Brentwood, TN 37027-5098
Authorised official
- Name
- Terrence Dillon
- Title
- Assistant Secretary
- Phone
- (502) 596-7220
Registered specialties
Physiological Laboratory
Primary
Registry record
- NPI
- 1255790499
- Entity type
- Organization
- NPI issued
- 16 Feb 2016
- Record last updated
- 25 Apr 2022
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.