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1790849453
AMY R WIELKOPOLAN
MURRELLS INLET, SC
NPI
1790849453
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
302R00000X Health Maintenance Organization
(Licence: SC 3663)
Enumeration Date
2006-12-20
Last Update Date
2007-07-08
Business Address
MS. AMY R WIELKOPOLAN LMBT
4370 CREPE MYRTLE CT UNIT A
MURRELLS INLET, SC 29576-4307
Phone number: 843-504-2905
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Mailing Address
MS. AMY R WIELKOPOLAN LMBT
4370 CREPE MYRTLE CT UNIT A
MURRELLS INLET, SC 29576-4307
Phone number: 843-504-2905
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