Individual
MICHELLE CAROLYN COLLYMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3402 MAYBANK ST, COLUMBIA, SC 29204-2858
(803) 728-0675
(803) 435-0786
Mailing address
3402 MAYBANK ST, COLUMBIA, SC 29204-2858
(803) 728-0675
(803) 435-0786
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
9691
SC
Other
Enumeration date
02/13/2020
Last updated
02/13/2020
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