Individual
OPHILLIA DOMINIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
501 RADFORD BLVD, DILLON, SC 29536-5001
(803) 605-0270
(843) 605-0268
Mailing address
3359 THORNBLADE DR, FLORENCE, SC 29501-8048
(856) 912-4867
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26107
SC
Other
Enumeration date
07/07/2022
Last updated
07/07/2022
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