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Individual

ALICIA NICOLE LANDRESS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
107 E MARION AVE, NORTH AUGUSTA, SC 29841-2935
(803) 426-8092
Mailing address
1831 ORIOLE AVE, NORTH AUGUSTA, SC 29841-3118
(803) 426-8092

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
332BC3200X
Customized Equipment (DME)
335E00000X
Prosthetic/Orthotic Supplier

Other

Enumeration date
02/19/2024
Last updated
09/08/2024
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