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MISS MARY LOUISE PERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPTA

Contact information

Practice address
720 RABON RD, COLUMBIA, SC 29203-8900
(803) 462-0423
(803) 462-9547
Mailing address
136 FIELD MOUNT RD, HOPKINS, SC 29061-9053
(803) 783-9123

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1708
SC

Other

Enumeration date
10/20/2006
Last updated
07/08/2007
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