Individual
TIEWANA BYNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2 LORD FAIRFAX DR, GREENVILLE, SC 29605-1432
(864) 553-0125
Mailing address
141 TRACTION ST, GREENVILLE, SC 29611-4725
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
N24102058
SC
Other
Enumeration date
03/28/2024
Last updated
03/28/2024
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