Individual
MIRANDA CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
6 K MART PLZ, GREENVILLE, SC 29605-4442
(864) 233-9551
Mailing address
6 K MART PLZ, GREENVILLE, SC 29605-4442
(864) 233-9551
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
03334412
OH
183500000X
Pharmacist
Primary
36282
SC
Other
Enumeration date
10/01/2015
Last updated
10/01/2015
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