JOHNNA REVIS

GRAY COURT, SC
NPI1205202413
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy320700000X Residential Treatment Facility, Physical Disabilities
(Licence: SC  1771)
Enumeration Date2015-08-12
Last Update Date2015-08-12
Business Address
JOHNNA REVIS PTA
5768 HIGHWAY 14
GRAY COURT, SC 29645-6764
Phone number: 864-872-2116
Mailing Address
JOHNNA REVIS PTA
5768 HIGHWAY 14
GRAY COURT, SC 29645-6764
Phone number: