Individual
SUSAN GRUBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
104 GEORGE BISHOP PKWY, MYRTLE BEACH, SC 29579-7335
(843) 903-6212
Mailing address
651 CARDINAL AVE, MYRTLE BEACH, SC 29577-5055
(843) 267-2727
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PR34015
SC
Other
Enumeration date
04/27/2022
Last updated
04/27/2022
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