Individual
MRS. MARY E SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
105 CHARLES ST, MULLINS, SC 29574-1801
(843) 464-3750
(843) 464-3755
Mailing address
719 N MAIN ST, MARION, SC 29571-2517
(843) 423-1811
(843) 423-8328
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P9461
SC
Other
Enumeration date
04/11/2013
Last updated
04/11/2013
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