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Individual

ELSIE CICONE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1500 WESTERN SQUARE, LAURENS, SC 29360-6664
(864) 365-6583
Mailing address
PO BOX 80223, SIMPSONVILLE, SC 29680-0004
(864) 365-6583

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
8250
TN
183500000X
Pharmacist
Primary
9589
SC

Other

Enumeration date
09/26/2013
Last updated
02/09/2015
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