Individual
MICHELLE THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1113 BELLEVIEW ST STE 103, COLUMBIA, SC 29201-1839
(803) 205-4006
Mailing address
1113 BELLEVIEW ST STE 103, COLUMBIA, SC 29201-1839
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P30452
SC
Other
Enumeration date
01/31/2020
Last updated
01/31/2020
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