Individual
KATELYN MARIA DANTZLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
701 GROVE RD, GREENVILLE, SC 29605
(864) 455-7000
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6307
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2225
SC
363A00000X
Physician Assistant
2283
WV
Other
Enumeration date
09/30/2014
Last updated
02/06/2020
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