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1023034865
RICHARD MOORER DANTZLER
CONWAY, SC
NPI
1023034865
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2006-07-14
Last Update Date
2007-07-08
Business Address
-- RICHARD MOORER DANTZLER
164 WACCAMAW MEDICAL PARK DR
CONWAY, SC 29526-8903
Phone number: 843-347-5060
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Mailing Address
-- RICHARD MOORER DANTZLER
1105 E ST
CONWAY, SC 29526-3342
Phone number: 843-488-0151
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