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Individual

NATASHA NICOLETTE COLVIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
422 N FRASER ST, GEORGETOWN, SC 29440-3260
(843) 904-9257
Mailing address
88 CHESTER AVE, GREAT FALLS, SC 29055-8871
(803) 209-5725

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
37051
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
37051
BOARD OF PHARMACY LICENSE
SC
Enumeration date
04/06/2020
Last updated
04/06/2020
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