Individual
LIESL EVA MALONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
415 OCEAN CREEK DR APT 2149, MYRTLE BEACH, SC 29572-5785
(603) 531-1770
Mailing address
415 OCEAN CREEK DR APT 2149, MYRTLE BEACH, SC 29572-5785
(603) 531-1770
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
SC
Other
Enumeration date
09/04/2024
Last updated
09/04/2024
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