Individual
MAYURI GANESANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
525 COLLEGE AVE, CLEMSON, SC 29631-1444
(864) 654-6050
Mailing address
103 WATERMARKE LN, ANDERSON, SC 29625-5961
(603) 505-7043
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13968
SC
Other
Enumeration date
11/20/2012
Last updated
11/20/2012
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