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Individual

MRS. KRISTINA COLIZZI WINDOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
450 AZALEA SQUARE BLVD, SUMMERVILLE, SC 29483-7321
(843) 871-6935
(843) 871-6935
Mailing address
450 AZALEA SQUARE BLVD, SUMMERVILLE, SC 29483-7321
(843) 871-6935
(843) 871-6935

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10938
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0202010677
PHARMACIST LICENSE
VA
01
10938
PHARMACIST LICENSE
SC
01
PS 39855
PHARMACIST LICENSE
FL
Enumeration date
05/17/2011
Last updated
05/24/2011
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