Individual
JOSIEANN MAURO ECCLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1714 TICKTON HALL RD, RIDGELAND, SC 29936-7719
(843) 757-9838
(843) 757-9667
Mailing address
PO BOX 3066, BLUFFTON, SC 29910-3066
(843) 757-9838
(843) 757-9667
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
A933
SC
Other
Enumeration date
06/23/2006
Last updated
07/08/2007
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