Organization
DESTINED CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHUFARREL HICKS (OWNER)
(843) 810-6555
Entity
Organization
Contact information
Practice address
3407 WILSHIRE BLVD APT 201, WILMINGTON, NC 28403-4278
(843) 810-6555
Mailing address
3407 WILSHIRE BLVD APT 201, WILMINGTON, NC 28403-4278
(843) 810-6555
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7675
SC
Other
Enumeration date
11/14/2013
Last updated
11/14/2013
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