Individual
CHRISTINE A STATOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
10457 HIGHWAY 221 S, WATERLOO, SC 29384-3910
(864) 677-4670
(864) 677-4674
Mailing address
10457 HIGHWAY 221 S, WATERLOO, SC 29384-3910
(864) 677-4670
(864) 677-4674
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P39793
SC
Other
Enumeration date
12/14/2016
Last updated
12/14/2016
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