| Active Life, LLC | |
|
125 Wappoo Creek Dr Suite 202 Charleston SC 29412-2163 | |
| (843) 588-5133 | |
| Not Available |
| Full Name | Active Life, LLC |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 125 Wappoo Creek Dr, Charleston, South Carolina |
| Authorized Official Name and Position | Kelly Erin O'neill (DOCTOR/OWNER) |
| Authorized Official Contact | 8435885133 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Active Life, LLC 125 Wappoo Creek Dr Suite 202 Charleston SC 29412-2163 Ph: (843) 588-5133 | Active Life, LLC 125 Wappoo Creek Dr Suite 202 Charleston SC 29412-2163 Ph: (843) 588-5133 |
| NPI Number | 1245549096 |
|---|---|
| Provider Enumeration Date | 09/28/2010 |
| Last Update Date | 09/28/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245549096 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 3574 (South Carolina) | Primary |
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