NPI 1457617540
Midlands Physical Medicine, LLC
Practice location
- Address
- 4531 Hard Scrabble Rd, Columbia, SC 29229-8561
- Phone
- (803) 419-8700
- Mailing address
- 2980 N Beverly Glen Cir Suite 301, Los Angeles, CA 90077-1726
Authorised official
- Name
- Kelvin J. Wiley
- Title
- Medical Director
- Phone
- (803) 419-8700
Registered specialties
Non-Pharmacy Dispensing Site
Primary
Registry record
- NPI
- 1457617540
- Entity type
- Organization
- NPI issued
- 3 Apr 2012
- Record last updated
- 3 Apr 2012
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.