Individual
AMANDA CELESTE DOMINICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 WADE HAMPTON BLVD, GREENVILLE, SC 29609-5735
(864) 900-6167
Mailing address
208 WARDLAW RD, LAURENS, SC 29360-3738
(864) 871-0560
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
42491
SC
Other
Enumeration date
06/25/2020
Last updated
06/25/2020
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