Individual
KELLY ALSUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
817 SAINT ANDREWS RD, COLUMBIA, SC 29210-5828
(803) 551-1145
Mailing address
817 SAINT ANDREWS RD, COLUMBIA, SC 29210-5828
(803) 551-1145
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12357
SC
Other
Enumeration date
02/06/2012
Last updated
02/06/2012
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