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1508563347
SAMANTHA JEAN THEOBALD
CHARLESTON, SC
NPI
1508563347
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: SC 27061)
Enumeration Date
2023-02-13
Last Update Date
2023-02-13
Business Address
SAMANTHA JEAN THEOBALD FNP
27 GAMECOCK AVE STE 201
CHARLESTON, SC 29407-3398
Phone number: 843-769-8215
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Mailing Address
SAMANTHA JEAN THEOBALD FNP
27 GAMECOCK AVE STE 201
CHARLESTON, SC 29407-3398
Phone number: 843-769-8215
Copy
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