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1689263352
KELLY LAROSE RIVERA
COLUMBIA, SC
NPI
1689263352
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2021-01-15
Last Update Date
2022-10-26
Business Address
KELLY LAROSE RIVERA PA-C
3 RICHLAND MEDICAL PARK DR STE 100
COLUMBIA, SC 29203-6850
Phone number: 803-736-3277
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Mailing Address
KELLY LAROSE RIVERA PA-C
15 EXCHANGE DR
LUGOFF, SC 29078-9198
Phone number: 803-736-3277
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