Individual
KAYLA MOODY BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
164 WACCAMAW MEDICAL PARK, CONWAY, SC 29526-8903
(843) 234-4888
Mailing address
151 WHISPERING OAKS DR, LONGS, SC 29568-6959
(843) 627-1111
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
237170
SC
Other
Enumeration date
09/07/2023
Last updated
09/07/2023
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