KENNASIA COAXUM
Individual Provider (NPI-1)
Active
Licensed Practical Nurse
Provider Information
- NPI Number
1093641763- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 469 GIANNA LN, GOOSE CREEK, SC, 294453672
- Phone
- (843) 781-0112
Specialties & Taxonomies
Licensed Practical Nurse
Primary License: SC #57100
All Addresses
MAILING
469 GIANNA LN
GOOSE CREEK, SC, 294453672