Individual
NACOLE DOMANIKA EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPT
Contact information
Practice address
108 ROE ST, GREER, SC 29651-1235
(864) 293-5607
Mailing address
108 ROE ST, GREER, SC 29651-1235
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CPT20-0756
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CPT20-0756
NPCE
NC
Enumeration date
04/27/2020
Last updated
04/27/2020
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