NPI 1093448508

Corona Lavetta Calvary

Practitioner Driver Summerville, SC

Practice location

Address: 412 Old Trolley Rd STE B, Summerville, SC 29485-5666
Phone: (843) 345-8178

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence 008818045 (SC)

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Registry record

NPI: 1093448508
Entity type: Individual
Sex (as registered): Female
NPI issued: 3 Jul 2022
Record last updated: 3 Jul 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.