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1215105085
MARY REGINA DORTENZO
AIKEN, SC
NPI
1215105085
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner Adult Health
(Licence: SC 4097)
Enumeration Date
2008-02-14
Last Update Date
2016-06-30
Business Address
MS. MARY REGINA DORTENZO RN-ANP
216 EDGEFIELD AVE NW
AIKEN, SC 29801-3910
Phone number: 803-648-4224
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Mailing Address
MS. MARY REGINA DORTENZO RN-ANP
2030 POWERS FERRY RD SE STE 120
ATLANTA, GA 30339-5016
Phone number: 803-648-4224
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