Individual
RICHARDEAN GIBSON WINGATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MLT
Contact information
Practice address
605 S DARGAN ST, FLORENCE, SC 29506-2544
(843) 245-4708
(843) 407-6607
Mailing address
PO BOX 376, FLORENCE, SC 29503-0376
(843) 245-4708
(843) 407-6607
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS7994
SC
Other
Enumeration date
09/26/2016
Last updated
09/26/2016
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