Individual
MRS. KRISTIN LEE CANTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
10630 CLEMSON BLVD STE 100, SENECA, SC 29678-4545
(864) 482-6000
(864) 482-7000
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
357
SC
363A00000X
Physician Assistant
Primary
PA357
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2212PA
—
SC
Enumeration date
03/29/2006
Last updated
05/04/2023
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