Individual
ELYSE E WERTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25 COURTENAY DR, CHARLESTON, SC 29425-8911
(843) 876-4948
Mailing address
171 ASHLEY AVE # MH383, CHARLESTON, SC 29425-0100
(843) 792-8312
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
00-9564
SC
Other
Enumeration date
09/28/2021
Last updated
09/28/2021
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