| Ktp Wellness Solution Llc | |
|
201 Columbia Mall Blvd Ste 189 Columbia SC 29223-7550 | |
| (803) 404-7418 | |
| (888) 958-0279 |
| Full Name | Ktp Wellness Solution Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 201 Columbia Mall Blvd Ste 189, Columbia, South Carolina |
| Authorized Official Name and Position | Thelisa Y Sulton (OWNER) |
| Authorized Official Contact | 8034047418 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ktp Wellness Solution Llc 201 Columbia Mall Blvd Ste 189 Columbia SC 29223-7550 Ph: (803) 404-7418 | Ktp Wellness Solution Llc 201 Columbia Mall Blvd Ste 189 Columbia SC 29223-7550 Ph: (803) 404-7418 |
| NPI Number | 1346888948 |
|---|---|
| Provider Enumeration Date | 12/13/2019 |
| Last Update Date | 02/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346888948 | NPI | - | NPPES |
| 12345678 | Other | SC | MULTI- SPECIALITY CLINIC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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