OrganizationActive
Advantage Integrated Medical
NPI 1013669126 · Physical Medicine & Rehabilitation Physician · Lexington, SC
Provider details
- NPI number
- 1013669126
- Entity type
- Organization
- Primary specialty
- Physical Medicine & Rehabilitation PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- David Gooldy, Authorized Official(803) 462-5440
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
Practice location
1926 S Lake Dr
Lexington, SC 29073-8282
Phone: (803) 462-5440
Approximate (ZIP-level) locationGet directions
Mailing address
1926 S Lake Dr
Lexington, SC 29073-8282
Registry dates
- Enumerated
- 2022-01-20
- Last updated
- 2022-01-20
- Certified
- 2022-01-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.