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General NPI Number Information
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NPI Number | 1295381531
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Entity Type | Individual
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Provider Name | TONYA CANDICE WEBER
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Gender | Female
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Dates
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Enumeration Date | 08/13/2019
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Last Update Date | 08/13/2019
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Provider Practice Location Address
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Address Line | 1016 2ND AVE N STE 205
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City | NORTH MYRTLE BEACH
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State | SC
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Zip | 29582-3288
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Country | US
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Telephone | 843-653-8007
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Fax |
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Provider Business Mailing Address
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Address Line | 2051 MARSH FLOWER LN
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City | CHARLESTON
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State | SC
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Zip | 29414-6435
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Country | US
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Telephone | 843-653-8901
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 95
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License Number State | SC
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