Provider Demographics
NPI:1457604142
Name:LOWCOUNTRY HEALTH GROUP LLC
Entity Type:Organization
Organization Name:LOWCOUNTRY HEALTH GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENS
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANZEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-376-5595
Mailing Address - Street 1:588 OLD MOUNT HOLLY ROAD
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-2773
Mailing Address - Country:US
Mailing Address - Phone:843-376-5595
Mailing Address - Fax:843-797-7432
Practice Address - Street 1:588 OLD MOUNT HOLLY ROAD
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-2773
Practice Address - Country:US
Practice Address - Phone:843-376-5595
Practice Address - Fax:843-797-7432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-18
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2773208100000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty