Individual
OLISHA CHAQUETTA THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
112 W MAIN ST, KINGSTREE, SC 29556-3344
(843) 624-8245
Mailing address
92 SMELTZER RD, KINGSTREE, SC 29556-9781
(843) 624-8245
Taxonomy
Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
—
—
Other
Enumeration date
09/19/2023
Last updated
09/19/2023
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