Individual
MR. BENNIE LEE STUCKEY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
54 HUDSON ST, BENNETTSVILLE, SC 29512-3930
(910) 384-5885
Mailing address
54 HUDSON ST, BENNETTSVILLE, SC 29512-3930
(910) 384-5885
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
007888897
SC
Other
Enumeration date
10/11/2012
Last updated
10/11/2012
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