Individual
MARIETTA KAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2243 WESTMINSTER HWY, WALHALLA, SC 29691-5023
(864) 958-0343
Mailing address
2243 WESTMINSTER HWY, WALHALLA, SC 29691-5023
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
42791
SC
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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