Individual
WANDA KAY MOULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2713 DUNLIN DR, FORT MILL, SC 29707-9118
(804) 350-9162
Mailing address
2713 DUNLIN DR, FORT MILL, SC 29707-9118
(804) 350-9162
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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