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Individual

MISS CONSTANTINHA CHARRON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
142 MANDY RD, CORDOVA, SC 29039
(803) 542-0638
Mailing address
142 MANDY RD, CORDOVA, SC 29039
(803) 542-0638

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2004-0000955
SC

Other

Enumeration date
10/16/2014
Last updated
10/16/2014
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