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Individual

MANDY MARIE SPENCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
105 DOCTORS DR, GREENVILLE, SC 29605-5608
(864) 797-7060
(864) 797-7065
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3125
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3891PA
SC
Enumeration date
09/16/2011
Last updated
05/06/2021
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