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General NPI Number Information
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NPI Number | 1588928832
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Entity Type | Organization
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Legal Business Name | ASSUAGE ETIQUETTE,LLC
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Dates
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Enumeration Date | 07/02/2012
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Last Update Date | 07/02/2012
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Provider Practice Location Address
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Address Line | 105 LOBLOLLY DR
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City | MONCKS CORNER
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State | SC
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Zip | 29461-3513
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Country | US
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Telephone | 843-751-6017
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Fax |
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Provider Business Mailing Address
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Address Line | 105 LOBLOLLY DR
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City | MONCKS CORNER
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State | SC
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Zip | 29461-3513
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Country | US
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Telephone | 843-751-6017
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MELANIE MCENDREE
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Credential | LMT, NMT
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Telephone | 843-751-6017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 7719
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License Number State | SC
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