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Individual

MR. WILLIE BENJAMIN FUNNYE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
515 BROAD ST, SUMTER, SC 29150-3354
(803) 469-4944
(803) 469-4344
Mailing address
2229 ROLLING HILL LN, SUMTER, SC 29150-1935
(803) 469-4944
(803) 469-4344

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary

Other

Enumeration date
12/08/2008
Last updated
12/08/2008
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