Individual
MRS. MICHELLE G SISTARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
1073 W MEETING ST, LANCASTER, SC 29720-2205
(803) 285-2021
(803) 285-7990
Mailing address
4503 JB DENTON RD, LANCASTER, SC 29720-9179
(803) 283-9292
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
10346
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10346
SC PHAR TECH REGISTRATION
SC
Enumeration date
02/15/2007
Last updated
07/08/2007
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