Provider Demographics
NPI:1801540414
Name:SKIN FIX SC LLC
Entity type:Organization
Organization Name:SKIN FIX SC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARALEE
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIPPEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-649-3909
Mailing Address - Street 1:1520 TWO NOTCH RD SE
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-5551
Mailing Address - Country:US
Mailing Address - Phone:803-649-3909
Mailing Address - Fax:
Practice Address - Street 1:1520 TWO NOTCH RD SE
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-5551
Practice Address - Country:US
Practice Address - Phone:803-649-3909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty