Individual
MRS. THERESA BAEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
3482 SHAGBARK CIR, MT PLEASANT, SC 29466-8089
(843) 881-0480
(843) 881-0480
Mailing address
3482 SHAGBARK CIR, MT PLEASANT, SC 29466-8089
(843) 881-0480
(843) 881-0480
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11352
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11352
SC BOARD OF PHARMACY
SC
Enumeration date
04/09/2010
Last updated
04/09/2010
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