Individual
KELLEY S WOMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2006 AUGUSTA HWY, LEXINGTON, SC 29072-2208
(803) 785-4747
(803) 785-4750
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
0000102753
NC
363AM0700X
Medical Physician Assistant
Primary
1847
SC
Other
Enumeration date
10/03/2006
Last updated
11/11/2020
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