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1225455074
ROOSEVELT STACKHOUSE
FLORENCE, SC
NPI
1225455074
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
163WH0200X Registered Nurse, Home Health
(Licence: SC 37318)
Enumeration Date
2014-03-18
Last Update Date
2014-03-18
Business Address
-- ROOSEVELT STACKHOUSE RN
1705 W EVANS ST
FLORENCE, SC 29501-3331
Phone number: 843-774-1577
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Mailing Address
-- ROOSEVELT STACKHOUSE RN
PO BOX 648 521 GILCHRIST ROAD
MULLINS, SC 29574-0648
Phone number: 843-464-0767
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