Individual
MIKE DESERIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3901 PELHAM RD, GREENVILLE, SC 29615
(864) 288-3672
Mailing address
3901 PELHAM RD, GREENVILLE, SC 29615
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
012216
SC
Other
Enumeration date
09/05/2012
Last updated
04/07/2021
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