Individual
KACI RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
574 ZIG ZAG BRANCH RD, PINELAND, SC 29934
(843) 252-1409
Mailing address
574 ZIG ZAG BRANCH RD, PINELAND, SC 29934
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
02/10/2021
Last updated
02/10/2021
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