Individual
MARY HARGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
312 BLOSSOM CT, LATTA, SC 29565-4524
(843) 506-4008
(843) 627-3673
Mailing address
312 BLOSSOM CT, LATTA, SC 29565-4524
(843) 506-4008
(843) 627-3673
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P34448
SC
Other
Enumeration date
04/05/2017
Last updated
04/05/2017
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