Individual
MRS. ALLIE COOPER REDDING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
600 N WHEELER AVE, PROSPERITY, SC 29127-9332
(803) 364-4852
(803) 364-2014
Mailing address
PO BOX 630, PROSPERITY, SC 29127-0630
(803) 364-4852
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
83218
SC
208D00000X
General Practice Physician
83218
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
SC
Other
Enumeration date
03/30/2020
Last updated
09/11/2023
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