NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
1790143766 |   |   |   | PROVIDENCE PHYSICIAN PRACTICES LLC | 114 GATEWAY CORPORATE BLVD | COLUMBIA | SC | 292039740 |
1912462003 | CORWIN | KAITLIN |   |   | 1655 BERNARDIN AVE STE 350 | COLUMBIA | SC | 292042039 |
1871802686 | DIEVENDORF | AMY | JEANETTE |   | 330 SEVEN SPRINGS WAY | BRENTWOOD | TN | 370275098 |
1023410370 | FREE | SABRINA | MARINA |   | 105 RED ASH LANE | LEXINGTON | SC | 29072 |
1790927630 | HYMON | MARIA | GEORGE |   | 114 GATEWAY CORPORATE BLVD. | COLUMBIA | SC | 29203 |
1124005897 | YOUNG | CAROL | RAY |   | PO BOX 3239 | FLORENCE | SC | 295023239 |