Individual
MRS. KENNAH JOHNSON BREARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3574 SUNSET BLVD, WEST COLUMBIA, SC 29169-3044
(803) 796-2500
Mailing address
3574 SUNSET BLVD, WEST COLUMBIA, SC 29169-3044
(803) 796-2500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1865
SC
Other
Enumeration date
11/29/2012
Last updated
04/30/2013
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