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1063883767
ALICIA PENDERGRASS
IRMO, SC
NPI
1063883767
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LX0001X Nurse Practitioner, Obstetrics & Gynecology
(Licence: SC 19686)
Enumeration Date
2015-10-07
Last Update Date
2022-12-20
Business Address
ALICIA PENDERGRASS FNP
1 WELLNESS BLVD STE 203
IRMO, SC 29063-2873
Phone number: 803-749-9920
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Mailing Address
ALICIA PENDERGRASS FNP
PO BOX 6069
WEST COLUMBIA, SC 29171-6069
Phone number: 803-749-9920
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