OrganizationActive
Age Well Sc LLC
NPI 1003614900 · Multi-Specialty Clinic/Center · Lexington, SC
Provider details
- NPI number
- 1003614900
- Entity type
- Organization
- Primary specialty
- Multi-Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Tjuana Seidl, Director(803) 646-0126
Specialties & taxonomies
Ambulatory Health Care Facilities
- Medical Physician Assistant363AM0700X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
468 Old Cherokee Rd
Lexington, SC 29072-9031
Phone: (803) 646-0126
Approximate (ZIP-level) locationGet directions
Mailing address
468 Old Cherokee Rd
Lexington, SC 29072-9031
Registry dates
- Enumerated
- 2025-03-05
- Last updated
- 2025-03-05
- Certified
- 2025-03-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.