Individual
DEBRA ANNE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2850 TRICOM ST, NORTH CHARLESTON, SC 29406-9192
(843) 863-1188
Mailing address
2850 TRICOM ST, NORTH CHARLESTON, SC 29406-9192
(843) 863-1188
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
11/11/2019
Last updated
07/23/2021
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