Individual
JONICA D RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
417 GRAND NATIONAL LN, ELGIN, SC 29045-7113
(803) 904-0052
Mailing address
417 GRAND NATIONAL LN, ELGIN, SC 29045-7113
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
06/04/2020
Last updated
06/04/2020
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