Individual
ISAAC WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4 KYLE PL, CHARLESTON, SC 29403-3616
(843) 834-4685
Mailing address
4 KYLE PL, CHARLESTON, SC 29403-3616
(843) 834-4685
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CPSS-2040
SC
Other
Enumeration date
05/13/2021
Last updated
05/13/2021
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