Individual
VIVIAN P MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
337 FAT BACK RD, DALZELL, SC 29040-8548
(803) 459-7448
Mailing address
337 FAT BACK RD, DALZELL, SC 29040-8548
(803) 459-7448
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
09/14/2021
Last updated
09/14/2021
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