Individual
KELLY LYNN QUIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
801 N HAMILTON ST, WILLIAMSTON, SC 29697-1061
(864) 847-7344
Mailing address
PO BOX 99, WILLIAMSTON, SC 29697-0099
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
184083
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104973577
—
SC
Enumeration date
06/06/2013
Last updated
06/06/2013
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