Individual
KIRSTEN BLYTHE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1304 W BOBO NEWSOM HWY, HARTSVILLE, SC 29550-4710
(843) 339-2100
Mailing address
602 ASCOT DR, FLORENCE, SC 29501-1913
(240) 539-4292
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4288
SC
Other
Enumeration date
11/04/2021
Last updated
02/28/2022
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