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1417978388
SALLY SELF
CHARLESTON, SC
NPI
1417978388
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology
(Licence: SC 9365)
Enumeration Date
2006-07-23
Last Update Date
2007-07-08
Business Address
-- SALLY SELF MD
171 ASHLEY AVE
CHARLESTON, SC 29425-0001
Phone number: 843-792-1414
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Mailing Address
-- SALLY SELF MD
PO BOX 751461
CHARLOTTE, NC 28275-1461
Phone number: 843-792-6200
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