Individual
AMANDA SHELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 SAINT JAMES AVE, GOOSE CREEK, SC 29445-2776
(843) 569-3114
Mailing address
600 SAINT JAMES AVE, GOOSE CREEK, SC 29445-2776
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
35529
SC
Other
Enumeration date
07/23/2015
Last updated
07/23/2015
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