Individual
CHANDLYN KELLI REYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
136 FAIR HILLS LOOP, COLUMBIA, SC 29209-3082
(803) 361-0138
Mailing address
136 FAIR HILLS LOOP, COLUMBIA, SC 29209-3082
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
52424
SC
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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