Individual
HUNTER WALLACE HARRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
890 W FARIS RD STE 580, GREENVILLE, SC 29605-4281
(864) 455-7874
(864) 455-8933
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4229
SC
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
SC
Enumeration date
02/19/2021
Last updated
01/13/2023
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