Individual
DEBRA BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
205 NORTH VAN LINGLE MUNGO BLVD, PAGELAND, SC 29728
(843) 672-2420
Mailing address
6972 SANDHILL RD, KERSHAW, SC 29067-8288
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8017
SC
Other
Enumeration date
09/14/2012
Last updated
09/14/2012
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