Individual
BONITA L WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
208 SONORA DR, EASLEY, SC 29640-9316
(864) 918-9637
Mailing address
PO BOX 14565, GREENVILLE, SC 29610-4565
(864) 918-9637
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
372600000X
Adult Companion
—
—
Other
Enumeration date
02/20/2023
Last updated
02/20/2023
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