Individual
CARLA DORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
21 STAR RD, EDGEFIELD, SC 29824
(803) 637-4035
Mailing address
21 STAR RD, EDGEFIELD, SC 29824
(803) 637-4035
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN.20194 P
SC
Other
Enumeration date
03/21/2014
Last updated
03/21/2014
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