Individual
QUIAN DONALD CARLISLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4 MAGNOLIA GLEN LN, COLUMBIA, SC 29205-4278
(184) 324-6229
Mailing address
4 MAGNOLIA GLEN LN, COLUMBIA, SC 29205-4278
(184) 324-6229
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6172
SC
Other
Enumeration date
05/04/2022
Last updated
05/04/2022
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