Individual
KELLI L WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
809 82ND PKWY, MYRTLE BEACH, SC 29572
(843) 692-1752
Mailing address
809 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(438) 692-1752
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
SC
Other
Enumeration date
09/07/2010
Last updated
03/04/2019
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