Individual
MRS. TAMARA LYNETTE WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10050 TWO NOTCH RD STE 7, COLUMBIA, SC 29223-4302
(803) 851-3353
Mailing address
494 MARSH POINTE DR, COLUMBIA, SC 29229-7025
(803) 319-0623
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
71362
SC
Other
Enumeration date
12/13/2019
Last updated
12/13/2019
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