Individual
HEATHER ANTLEY MOUNT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1550 CAROLINA AVE, ORANGEBURG, SC 29115-4944
(803) 533-5480
Mailing address
1550 CAROLINA AVE, ORANGEBURG, SC 29115-4944
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary
95741
SC
Other
Enumeration date
02/11/2022
Last updated
02/11/2022
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