Individual
ANTONIO ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
250 DEWEY AVE, SPARTANBURG, SC 29303-3009
(186) 440-6811
Mailing address
250 DEWEY AVE, SPARTANBURG, SC 29303-3009
(186) 440-6811
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
48558
SC
Other
Enumeration date
10/11/2023
Last updated
10/11/2023
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