Individual
KYLIE MADISON DEICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10 MCCLENNAN BANKS DR, CHARLESTON, SC 29401-1164
(843) 985-1590
Mailing address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(972) 533-9334
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86152837
SC
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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