NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1073086377
ACTIVE SC ONE, INC.
6 NESHAMINY INTERPLEX, SUITE 401
TREVOSE
PA
19053
1265953590
CLUB HORIZONS OF CHARLESTON, LLC
170 COURTHOUSE SQ
FLORENCE
SC
295013432
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