Individual
SAVANNAH ROOF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
166 STONERIDGE DR, COLUMBIA, SC 29210-8239
(803) 461-3000
Mailing address
166 STONERIDGE DR, COLUMBIA, SC 29210-8239
(803) 461-3000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
07/27/2018
Last updated
12/31/2019
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