Individual
JESSICA MCKEOWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3700 TWO NOTCH ROAD, COLUMBIA, SC 29204
(803) 786-0158
Mailing address
10 BARBERRY LANE, COLUMBIA, SC 29212
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11840
SC
Other
Enumeration date
09/13/2012
Last updated
09/13/2012
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