MADISON BLAIRE KENT

LORIS, SC
NPI1629849302
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: SC  28278)
Enumeration Date2024-01-11
Last Update Date2024-01-11
Business Address
MADISON BLAIRE KENT
4520 BROAD ST
LORIS, SC 29569-2422
Phone number: 843-756-0959
Mailing Address
MADISON BLAIRE KENT
4206 SEAVIEW ST APT 2
NORTH MYRTLE BEACH, SC 29582-5142
Phone number: 864-430-9948