AMY R WIELKOPOLAN

MURRELLS INLET, SC
NPI1790849453
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy302R00000X Health Maintenance Organization
(Licence: SC  3663)
Enumeration Date2006-12-20
Last Update Date2007-07-08
Business Address
Ms. AMY R WIELKOPOLAN lmbt
4370 CREPE MYRTLE CT UNIT A
MURRELLS INLET, SC 29576-4307
Phone number: 843-504-2905
Mailing Address
Ms. AMY R WIELKOPOLAN lmbt
4370 CREPE MYRTLE CT UNIT A
MURRELLS INLET, SC 29576-4307
Phone number: 843-504-2905