OrganizationActive
Active Life, LLC
NPI 1245549096 · Primary Care Clinic/Center · Charleston, SC
Provider details
- NPI number
- 1245549096
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Kelly O'Neill, Doctor/Owner(843) 588-5133
- License
- 3574 (SC)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
125 Wappoo Creek Dr
Suite 202
Charleston, SC 29412-2163
Phone: (843) 588-5133
Approximate (ZIP-level) locationGet directions
Mailing address
125 Wappoo Creek Dr
Charleston, SC 29412-2163
Registry dates
- Enumerated
- 2010-09-28
- Last updated
- 2010-09-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.