Individual
SHANNON DAWN KRETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
164 WACCAMAW MEDICAL PARK DR, CONWAY, SC 29526-8903
(843) 347-4888
Mailing address
164 WACCAMAW MEDICAL PARK DR, CONWAY, SC 29526-8903
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PR40574
SC
Other
Enumeration date
01/24/2013
Last updated
01/24/2013
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