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1174545321
FARA MOORE FOWLER
CONWAY, SC
NPI
1174545321
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163WP0809X Registered Nurse, Psych/Mental Health, Adult
(Licence: SC 00026004)
Enumeration Date
2006-07-24
Last Update Date
2007-07-08
Business Address
-- FARA MOORE FOWLER RNC
164 WACCAMAW MEDICAL PARK DR
CONWAY, SC 29526-8903
Phone number: 843-347-5060
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Mailing Address
-- FARA MOORE FOWLER RNC
121 CLEMSON RD
CONWAY, SC 29526-8830
Phone number: 843-347-6564
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