Individual
MRS. MARY M BRUNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1028 GRAND CONCOURSE ST, CHARLESTON, SC 29412-8828
(843) 795-9294
Mailing address
1028 GRAND CONCOURSE ST, CHARLESTON, SC 29412-8828
(843) 795-9294
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P26670
SC
Other
Enumeration date
08/13/2009
Last updated
08/13/2009
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