Organization
PARKWAY ANESTHESIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY C. WILT (OWNER/MEMBER)
(843) 492-5679
Entity
Organization
Contact information
Practice address
827 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 492-5679
Mailing address
PO BOX 1547, COLUMBIA, SC 29202-1547
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
06/24/2010
Last updated
06/24/2010
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