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Individual

MRS. LUCY CAROLINE BAXLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
719 N MAIN ST, MARION, SC 29571-2517
(843) 423-1811
Mailing address
719 N MAIN ST, MARION, SC 29571-2517
(843) 423-1811

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P38753
SC

Other

Enumeration date
04/09/2013
Last updated
04/09/2013
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