Individual
BERNADETTE POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9395 FOUNDERS ST, FORT MILL, SC 29708-6417
(864) 404-8424
Mailing address
9395 FOUNDERS ST, FORT MILL, SC 29708-6417
(864) 404-8424
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4441
SC
Other
Enumeration date
06/23/2022
Last updated
06/23/2022
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