Individual
MRS. MICA LAUREN BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
515 S HAMPTON ST, KERSHAW, SC 29067-1834
(803) 475-7370
Mailing address
515 S HAMPTON ST, KERSHAW, SC 29067-1834
(803) 475-7370
(803) 475-5531
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13860
SC
Other
Enumeration date
08/17/2012
Last updated
02/20/2021
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