Individual
MIKELL STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
720 E FRONT ST, IVA, SC 29655-9089
(864) 348-6138
Mailing address
1116 KEONE CIR, WILLIAMSTON, SC 29697-9243
(864) 617-1817
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11118
SC
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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