Individual
DEBRA TODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1931 INDUSTRIAL PARK RD, CONWAY, SC 29526-5482
(843) 915-8745
Mailing address
1931 INDUSTRIAL PARK RD, CONWAY, SC 29526-5482
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
21893
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8433857822
—
SC
Enumeration date
11/19/2019
Last updated
11/19/2019
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