Individual
HIWOT PAULOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8310 HIBISCUS LN, INDIAN LAND, SC 29707-5022
(404) 374-1068
Mailing address
5222 OLD HICKORY ROAD, SUITE 19, VAN WYCK, SC 29744
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
9774SF
SC
Other
Enumeration date
03/17/2025
Last updated
03/17/2025
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