Individual
HEATHER C. MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6167 BRAIDED MANE PASS SW, AIKEN, SC 29803-7839
(803) 648-1464
(803) 649-2027
Mailing address
PO BOX 485, COLUMBIA, SC 29202-0485
(803) 898-8405
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
A850
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0293PA
—
SC
Enumeration date
11/01/2006
Last updated
10/31/2024
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