Individual
MRS. MARY C. NETTLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
7210L BROAD RIVER RD, IRMO, SC 29063-7973
(803) 749-1576
Mailing address
140 WILLA DR, COLUMBIA, SC 29209-4353
(803) 261-5319
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4530
SC
Other
Enumeration date
08/07/2008
Last updated
08/07/2008
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