Individual
MS. COURTNEY SHAREE PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RC 72216
Contact information
Practice address
9320 TWO NOTCH RD STE A, COLUMBIA, SC 29223-6402
(803) 238-6608
Mailing address
6625 VALLEYBROOK RD, COLUMBIA, SC 29206-1052
(803) 238-6608
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
72216
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
800541897
—
SC
Enumeration date
05/16/2022
Last updated
05/16/2022
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