Provider Demographics
NPI:1790394559
Name:LCM2 LLC
Entity type:Organization
Organization Name:LCM2 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TWILLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-572-7715
Mailing Address - Street 1:9231 MEDICAL PLAZA DR STE E
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9101
Mailing Address - Country:US
Mailing Address - Phone:843-572-7715
Mailing Address - Fax:843-936-6452
Practice Address - Street 1:9231 MEDICAL PLAZA DR STE E
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9101
Practice Address - Country:US
Practice Address - Phone:843-572-7715
Practice Address - Fax:843-936-6452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Single Specialty