Individual
ASHLEY V MEZZANOTTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-6000
Mailing address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1916PA
—
SC
Enumeration date
06/19/2013
Last updated
10/23/2015
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