KACY CLINKENBEARD

CHARLESTON, SC
NPI1417579269
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: SC  4063)
Additional Taxonomies363A00000X Physician Assistant
(Licence: KY  TC962)
363AM0700X Physician Assistant, Medical
(Licence: KY  TC962)
363AS0400X Physician Assistant, Surgical
(Licence: KY  TC962)
Enumeration Date2020-05-15
Last Update Date2021-10-06
Business Address
KACY CLINKENBEARD
171 ASHLEY AVE
CHARLESTON, SC 29425-8908
Phone number: 843-792-2300
Mailing Address
KACY CLINKENBEARD
PO BOX 751461
CHARLOTTE, NC 28275-1461
Phone number: 843-792-6200