Individual
AUSTRALIA VAN DYKE GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
10 E HOSPITAL ST, MANNING, SC 29102-3153
(803) 435-8463
(803) 435-5288
Mailing address
PO BOX 3239, FLORENCE, SC 29502-3239
(843) 777-5098
(843) 777-7102
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
20008
SC
Other
Enumeration date
02/27/2016
Last updated
01/20/2017
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