Organization
FOREST FAMILY PRACTICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DEBORAH TULLY (BUSINESS MANAGER)
(843) 903-4401
Entity
Organization
Contact information
Practice address
3874 RENEE DRIVE, SUITE B, MYRTLE BEACH, SC 29579
(843) 903-4401
Mailing address
3874 RENEE DRIVE, SUITE B, MYRTLE BEACH, SC 29579
(843) 903-4401
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F 2018
SC
Other
Enumeration date
04/09/2007
Last updated
08/22/2020
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