Individual
MR. MACK CARLTON HARVEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1400 OLD TAMAH RD, IRMO, SC 29063-9799
(803) 732-8055
(803) 732-8064
Mailing address
18 BAMBOO GROVE CT, CHAPIN, SC 29036-7523
(803) 781-9149
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
243
SC
Other
Enumeration date
04/20/2006
Last updated
07/08/2007
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