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Candyce S. Mcleod
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NPI Number Detailed Information
Provider Information:
| Name: | Candyce S. Mcleod |
| Gender: | F |
| Provider License Number If Given: | 45938 |
NPI Information:
| NPI: | 1730188277 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 7/18/2005 |
| Last Update Date: | 12/8/2015 |
Provider Business Mailing Address:
| Address: | 1624 MAIN STREET AGAPE SENIOR PRIMARY CARE, INC., DBA LTC HEALTH SOLUTIO Columbia, SC 29201 |
| Phone Number: | 8034540365 |
| Fax Number: | 8034046000 |
Provider Business Practice Location Address:
| Address: | 9302 MEDICAL PLAZA DRIVE, SUITE C LTC HEALTH SOLUTIONS Charleston, SC 29406 |
| Phone Number: | 8437970416 |
| Fax Number: | 8438474477 |
Provider Taxonomy:
| Primary: | 164W00000X |
| Secondary (if any): | 363LF0000X |
| State: | SC |
