Individual
MELISSA WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
975 BACONS BRIDGE RD, SUMMERVILLE, SC 29485-4118
(843) 871-0473
Mailing address
9657 GODWIN ST, LADSON, SC 29456-6730
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
35801
SC
Other
Enumeration date
02/27/2015
Last updated
02/27/2015
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