Individual
MRS. DOROTHY MARIE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 577-5011
(843) 789-6186
Mailing address
135 SHADOWMOSS PKWY, CHARLESTON, SC 29414-6857
(843) 766-9991
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1992
SC
Other
Enumeration date
09/27/2006
Last updated
07/08/2007
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