Individual
DR. TIFFANEY B THREATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1941 BLOSSOM ST, COLUMBIA, SC 29205-2217
(803) 212-1015
(803) 212-4695
Mailing address
1941 BLOSSOM ST, COLUMBIA, SC 29205-2217
(803) 212-1015
(803) 212-4695
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
009315
SC
Other
Enumeration date
02/25/2011
Last updated
02/25/2011
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