Individual
KAYLEE QUATTLEBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
102 ROCKCREEK BLVD, GREENWOOD, SC 29649-8915
(864) 725-5020
Mailing address
102 ROCKCREEK BLVD, GREENWOOD, SC 29649-8915
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4659
SC
Other
Enumeration date
11/02/2022
Last updated
11/02/2022
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