Individual
MAZIE SUNSHINE UNDERWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC, CSCS
Contact information
Practice address
1951 CLEMENTS FERRY RD, CHARLESTON, SC 29492-8322
(843) 797-5050
Mailing address
1951 CLEMENTS FERRY RD, CHARLESTON, SC 29492-8322
(843) 797-5050
(843) 797-3633
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1906
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1906
SC DHEC
SC
Enumeration date
07/22/2019
Last updated
07/22/2019
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