Individual
BLANCA ELCY JARDEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SA-C
Contact information
Practice address
1137 STONEY FALLS BLVD, MYRTLE BEACH, SC 29579-4182
(631) 455-1384
Mailing address
1137 STONEY FALLS BLVD, MYRTLE BEACH, SC 29579-4182
(631) 455-1384
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
19-282
SC
Other
Enumeration date
09/20/2019
Last updated
09/20/2019
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