| Upstate Ketamine and Wellness Center | |
|
130 Dillon Dr Spartanburg SC 29307-1018 | |
| (864) 365-3000 | |
| Not Available |
| Full Name | Upstate Ketamine and Wellness Center |
|---|---|
| Speciality | General Practice |
| Location | 130 Dillon Dr, Spartanburg, South Carolina |
| Authorized Official Name and Position | Jason Blasenak (MEMBER) |
| Authorized Official Contact | 8645330029 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Upstate Ketamine and Wellness Center 2391 Roper Mountain Rd Simpsonville SC 29681-4937 | Upstate Ketamine and Wellness Center 130 Dillon Dr Spartanburg SC 29307-1018 Ph: (864) 365-3000 |
| NPI Number | 1518646041 |
|---|---|
| Provider Enumeration Date | 07/12/2023 |
| Last Update Date | 07/12/2023 |
| Certification Date | 07/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518646041 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
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