Individual
TYQUAN RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3011 OLD CREEK RD, SCRANTON, SC 29591-5652
(843) 598-6480
Mailing address
3011 OLD CREEK RD, SCRANTON, SC 29591-5652
(843) 598-6480
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
251E00000X
SC
374U00000X
Home Health Aide
Primary
99-3873048
SC
Other
Enumeration date
07/08/2024
Last updated
07/08/2024
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