Individual
LOIS JEAN PAVKOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
100 JOSEPH WALKER DR, WEST COLUMBIA, SC 29169-6971
(803) 936-0310
(803) 926-9599
Mailing address
34 WOODCROSS DR APT 1202, COLUMBIA, SC 29212-2365
(803) 719-2206
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2310
SC
Other
Enumeration date
11/29/2016
Last updated
11/29/2016
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