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1689226557
ANNA ILIASOVA
COLUMBIA, SC
NPI
1689226557
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: SC 22826)
Enumeration Date
2019-07-11
Last Update Date
2019-07-15
Business Address
ANNA ILIASOVA
400 PALMETTO HEALTH PKWY
COLUMBIA, SC 29212-1760
Phone number: 803-907-7000
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Mailing Address
ANNA ILIASOVA
PO BOX 743904
ATLANTA, GA 30374-3904
Phone number: 803-296-7320
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