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Individual

ULYESSE C EVERALL III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
N.P.

Contact information

Practice address
1317 EBENEZER RD, AGAPE PHYSICIANS CARE, ROCK HILL, SC 29732-2336
(803) 207-8200
(803) 207-8130
Mailing address
1624 MAIN STREET AGAPE SENIOR PRIMARY CARE, INC.,, DBA AGAPE PHYSICIANS CARE, COLUMBIA, SC 29201
(803) 454-0365
(803) 404-6000

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN18357
SC

Other

Enumeration date
07/08/2013
Last updated
09/02/2014
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