Individual
DYNA PARAOAN CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1748 SAINT MATTHEWS RD, ORANGEBURG, SC 29118-2441
(803) 536-0613
(803) 536-2876
Mailing address
PO BOX 749306, ATLANTA, GA 30374-9306
(803) 536-0613
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
104112
NC
363A00000X
Physician Assistant
Primary
5103
SC
Other
Enumeration date
07/16/2007
Last updated
10/30/2024
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