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Individual

MARSHA LYNN PICCUTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
101 LOCUST ST, LYMAN, SC 29365-1503
(864) 439-1040
(864) 949-0461
Mailing address
139 RIVER FALLS DR, DUNCAN, SC 29334-9257
(864) 439-1040
(864) 949-0461

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
009334
SC
183500000X
Pharmacist
RP038548L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
009334
SOUTH CAROLINA PHARMACIST LICENSE
SC
01
RP038548L
PENNSYLVAINIA PHARMACIST LICENSE
PA
Enumeration date
08/27/2012
Last updated
08/27/2012
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