Individual
KOCYFICA L ETHEREDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6 MORNINGSIDE DR, GREENVILLE, SC 29605-2218
(864) 275-7156
Mailing address
6 MORNINGSIDE DR, GREENVILLE, SC 29605-2218
(864) 275-7156
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
35430
SC
Other
Enumeration date
12/14/2020
Last updated
08/01/2026
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