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1821565334
GRACE WIELICKI COUCH
SUMTER, SC
NPI
1821565334
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: SC 22307)
Enumeration Date
2018-11-01
Last Update Date
2018-11-01
Business Address
GRACE WIELICKI COUCH FNP-C
325 BROAD ST
SUMTER, SC 29150-4167
Phone number: 803-773-5227
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Mailing Address
GRACE WIELICKI COUCH FNP-C
101 OLD GEORGETOWN RD
MANNING, SC 29102-2721
Phone number: 803-460-5151
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