Mustang Medicine Works, LLC
Counselor, Professional in Liberty, SC. Organization (NPI-2).
NPI number1124428016
StatusActive
Last updated in NPPESAug 27, 2014
Details
- NPI
- 1124428016
- Entity type
- Organization (NPI-2)
- Legal business name
- Mustang Medicine Works, LLC
- Organization subpart
- No
- Enumeration date
- Aug 27, 2014
- Last updated
- Aug 27, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 5933 | SC | Yes |
Practice location
5642 Moorefield Memorial Hwy.Liberty, SC 29657
Phone 864-508-0781
Mailing address
Po Box 702Liberty, SC 29657-0702
Phone 864-508-0781
Authorized official
Darrell Gene Yardley
Director
8645080781
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