Individual
SKYLAR BRYNN HUDGENS-WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
208 AMELIA OAKS WAY, COLUMBIA, SC 29209-1753
(678) 832-9239
Mailing address
208 AMELIA OAKS WAY, COLUMBIA, SC 29209-1753
(678) 832-9239
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/11/2020
Last updated
07/11/2020
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