Individual
MRS. STEPHANIE B CORPOLONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
109 W MAIN ST, MONCKS CORNER, SC 29461-2673
(843) 719-4600
Mailing address
3 LINDENDALE AVE, CHARLESTON, SC 29407-7227
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001237902
VA
Other
Enumeration date
01/09/2015
Last updated
01/09/2015
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