Individual
MRS. MALLORY BUNTON ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
131 SUMMERPLACE DR, WEST COLUMBIA, SC 29169-3058
(803) 794-4585
(803) 796-8924
Mailing address
131 SUMMERPLACE DR, WEST COLUMBIA, SC 29169-3058
(803) 794-4585
(803) 796-8924
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
18187
SC
Other
Enumeration date
02/27/2013
Last updated
02/27/2013
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