Individual
NICOLE JANAY PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1720 DUTCH FORK RD STE D, IRMO, SC 29063-8871
(803) 331-4028
Mailing address
34 WOODCROSS DR APT 409, COLUMBIA, SC 29212-2359
(803) 331-4028
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8268
SC
Other
Enumeration date
08/31/2018
Last updated
08/31/2018
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