Individual
ALY BISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5 RICHLAND MEDICAL PARK DR, COLUMBIA, SC 29203-6863
(803) 434-7151
Mailing address
104 CREEK VISTA WAY, COLUMBIA, SC 29206-3153
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
25878
SC
Other
Enumeration date
01/16/2022
Last updated
03/07/2022
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