Individual
MRS. SANDI R. VANHOOSIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1850 LAUREL ST, COLUMBIA, SC 29201
(803) 256-3400
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 1665
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
310497
TENNESSEE LIC. RENEWAL NO
TN
01
—
PA 1665
STATE OF SOUTH CAROLINA PA LICENSE
SC
01
—
PA0000001184
TENNESSEE LIC. NUMBER
TN
Enumeration date
09/17/2006
Last updated
03/22/2024
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