Provider Demographics
NPI:1356088710
Name:L&M HOLISTIC HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:L&M HOLISTIC HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:MRS
Authorized Official - First Name:CELISTA
Authorized Official - Middle Name:LC
Authorized Official - Last Name:MCKENZIE
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:843-610-4163
Mailing Address - Street 1:PO BOX 387
Mailing Address - Street 2:
Mailing Address - City:OLANTA
Mailing Address - State:SC
Mailing Address - Zip Code:29114-0387
Mailing Address - Country:US
Mailing Address - Phone:843-687-2509
Mailing Address - Fax:843-773-6204
Practice Address - Street 1:491 W CHEVES ST STE E
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4407
Practice Address - Country:US
Practice Address - Phone:843-610-4163
Practice Address - Fax:843-773-6204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care