Individual
SELENA WITHERSPOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5033 DICK POND RD UNIT A, MYRTLE BEACH, SC 29588-9680
(843) 220-0050
Mailing address
2804 OPHELIA WAY, MYRTLE BEACH, SC 29577-6784
(704) 299-6382
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
SC
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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