Individual
TEIA AVERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
437 TALBERT RD APT B3, MC CORMICK, SC 29835-6269
(864) 602-3539
Mailing address
437 TALBERT RD APT B3, MC CORMICK, SC 29835-6269
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EA6128
—
SC
Enumeration date
09/28/2020
Last updated
09/28/2020
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