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Individual

MRS. BONNIE BROWN WEST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-8160
Mailing address
1523 PRICE HOUSE RD, ROEBUCK, SC 29376-4013
(864) 476-8962

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
A403
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0054PA
SC
Enumeration date
04/03/2006
Last updated
05/20/2008
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