Individual
MARY ALICE KENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
170 AMENDMENT AVE, ROCK HILL, SC 29732-3073
(803) 324-7607
(803) 324-4097
Mailing address
170 AMENDMENT AVE, ROCK HILL, SC 29732-3073
(803) 324-7607
(860) 233-5212
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2289
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001239
MEDICAL LICENSE
CT
Enumeration date
01/03/2007
Last updated
09/23/2019
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