Individual
FEDORA MCGILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
117 N MCALLISTER ST, LAKE CITY, SC 29560-2421
(843) 956-7131
Mailing address
117 N MCALLISTER ST, LAKE CITY, SC 29560-2421
(843) 956-7131
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
—
SC
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
09/23/2025
Last updated
09/23/2025
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