Individual
JOANNA MANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, SCAT
Contact information
Practice address
3302 ROBERT M GRISSOM PKWY, MYRTLE BEACH, SC 29577-6401
(843) 488-7149
Mailing address
501 HAY HILL LN UNIT A, MYRTLE BEACH, SC 29579-4292
(704) 778-5612
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
1817
SC
Other
Enumeration date
02/15/2016
Last updated
02/15/2016
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