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Individual

HAILEY BETH LIBENGOOD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
135 RUTLEDGE AVE, CHARLESTON, SC 29425-8903
(843) 792-3328
Mailing address
PO BOX 1245, ORANGEBURG, SC 29116-1245
(803) 395-4497
(803) 395-2237

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2445
SC

Other

Enumeration date
01/29/2016
Last updated
08/05/2016
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