Individual
MS. BONNIE LEE BLUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.N.A
Contact information
Practice address
4023 E NATIONAL CEMETERY RD, FLORENCE, SC 29506-5238
(843) 229-2201
Mailing address
4023 E NATIONAL CEMETERY RD, FLORENCE, SC 29506-5238
(843) 229-2201
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
062729
SC
Other
Enumeration date
08/08/2006
Last updated
07/08/2007
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