Healthcare Provider Details

I. General information

NPI: 1558181503
Provider Name (Legal Business Name): STYLES BY RMARIE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2024
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5592 ROSEBANK RD
WADMALAW ISLAND SC
29487-7011
US

IV. Provider business mailing address

5592 ROSEBANK RD
WADMALAW ISLAND SC
29487-7011
US

V. Phone/Fax

Practice location:
  • Phone: 843-729-8540
  • Fax:
Mailing address:
  • Phone: 843-729-8540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: RASHEEDA CLARK
Title or Position: CRANIAL PROSTHESIS
Credential:
Phone: 843-729-8540