Individual
AMANDA COWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
107 MELVIN LN, WILLIAMSTON, SC 29697-9363
(864) 847-7377
(864) 847-3502
Mailing address
PO BOX 99, WILLIAMSTON, SC 29697-0099
(864) 847-7377
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
48154
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104973577
—
SC
Enumeration date
12/03/2013
Last updated
12/03/2013
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