Individual
THERESA KRAFNICK DYCHES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
129 NORTH MAIN ST, WAGENER, SC 29164-0129
(803) 564-5381
(803) 564-5398
Mailing address
PO BOX 129, WAGENER, SC 29164-0129
(803) 564-5381
(803) 564-5398
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8488
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME1001
—
SC
Enumeration date
08/31/2006
Last updated
07/08/2007
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