KELLY LAROSE RIVERA

COLUMBIA, SC
NPI1689263352
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
Enumeration Date2021-01-15
Last Update Date2022-10-26
Business Address
KELLY LAROSE RIVERA PA-C
3 RICHLAND MEDICAL PARK DR STE 100
COLUMBIA, SC 29203-6850
Phone number: 803-736-3277
Mailing Address
KELLY LAROSE RIVERA PA-C
15 EXCHANGE DR
LUGOFF, SC 29078-9198
Phone number: 803-736-3277