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Individual

MS. ELLEN J MATHESON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, CNS, LMT

Contact information

Practice address
621 WAPPOO RD, SEED OF LIFE COLLECTIVE, CHARLESTON, SC 29407-1800
(843) 410-8567
Mailing address
2948 CATHEDRAL LN, CHARLESTON, SC 29414-7309
(843) 324-5736

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
172M00000X
Mechanotherapist
6744
SC

Other

Enumeration date
09/08/2016
Last updated
09/29/2016
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