PORT CITY PLASTIC SURGERY, LLC
Radiology at Lake Park Dr, Charleston, SC

License number
South Carolina 200096
Category
Radiology
Type
Plastic and Reconstructive Surgery
Owner
Name: DR. BRIAN G WIDENHOUSE M.D.
Title: OWNER
Phone: (843) 856-8398
Address
Address
2683 Lake Park Dr, Charleston, SC 29406
National Provider ID: 1437385788
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about PORT CITY PLASTIC SURGERY, LLC at bizstanding.com

PORT CITY PLASTIC SURGERY, LLC

846 Dunhm St, Charleston, SC 29492

Registration:
May 26, 2009
Business type:
Domestic
Formation place:
SOUTH CAROLINA
Agent:
Brian G. Widenhouse, M.d

Radiology licenses in South Carolina










Other Doctors licenses in South Carolina