Individual
MR. CARL VINCENT WITHERSPOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
239 ACCESS RD, SPARTANBURG, SC 29303-1682
(864) 503-0207
Mailing address
239 ACCESS RD, SPARTANBURG, SC 29303-1682
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
24148
SC
Other
Enumeration date
09/19/2020
Last updated
09/19/2020
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