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Individual

NIKITA MACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
55 CROOKED CREEK PL, COLUMBIA, SC 29229-7196
(803) 250-7396
Mailing address
55 CROOKED CREEK PL, COLUMBIA, SC 29229-7196
(803) 250-7396

Taxonomy

Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
2016-51567-50461
SC

Other

Enumeration date
05/17/2016
Last updated
05/17/2016
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