Basic Information
| Provider Information | |||||||||
| NPI: | 1366869190 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WINNING HEALTH WELLNESS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 966 HOUSTON NORTHCUTT BLVD | ||||||||
| Address2: | |||||||||
| City: | MOUNT PLEASANT | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294643487 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8434710375 | ||||||||
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| Practice Location | |||||||||
| Address1: | 966 HOUSTON NORTHCUTT BLVD | ||||||||
| Address2: | |||||||||
| City: | MOUNT PLEASANT | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294643487 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8434710375 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2014 | ||||||||
| LastUpdateDate: | 03/18/2014 | ||||||||
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| AuthorizedOfficialLastName: | MCMARLIN | ||||||||
| AuthorizedOfficialFirstName: | ANDREW | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | D.O | ||||||||
| AuthorizedOfficialTelephone: | 8434710375 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QS0010X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine |
No ID Information.