Individual
CARLY A THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2067 CHARLIE HALL BLVD, CHARLESTON, SC 29414-5834
(843) 573-2535
Mailing address
47 DUNNEMANN AVE, CHARLESTON, SC 29403-3632
(843) 247-5627
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
26662
SC
Other
Enumeration date
10/05/2022
Last updated
10/05/2022
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