Individual
MR. DOUGLAS HANSFORD NETTERVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
248 IVY WOODS CT, FOUNTAIN INN, SC 29644-9256
(901) 334-8542
Mailing address
248 IVY WOODS CT, FOUNTAIN INN, SC 29644-9256
(901) 334-8542
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH-3585
SC
Other
Enumeration date
10/22/2020
Last updated
10/22/2020
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