Individual
MR. ANTONIO LAMAR RIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
HAIR LOSS SPECIALIS
Contact information
Practice address
2702 W SURREY DR, NORTH CHARLESTON, SC 29405-5513
(843) 224-3574
Mailing address
2702 W SURREY DR, NORTH CHARLESTON, SC 29405-5513
(843) 224-3574
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
2677
SC
Other
Enumeration date
08/16/2020
Last updated
08/16/2020
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