Individual
URSULA TREADAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3609 OUTDOOR SPORTSMAN PL STE 7, KODAK, TN 37764-1477
(652) 815-9228
(865) 766-5396
Mailing address
PO BOX 3439, NORTH MYRTLE BEACH, SC 29582-0439
(843) 839-4447
(843) 399-0123
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
02/01/2017
Last updated
12/11/2019
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