Individual
KATHERINE STANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
103 HICKORY MILL CT, LAKE WYLIE, SC 29710-8805
(803) 981-4394
Mailing address
103 HICKORY MILL CT, LAKE WYLIE, SC 29710-8805
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2811
SC
Other
Enumeration date
02/20/2018
Last updated
02/20/2018
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