Provider Information for 1104358548
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NANCY PUROHIT
Sex: Female
NPI: 1104358548
Last Updated: 2017-04-03
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1104358548 | ||||||||
| Enumeration Date | 2017-04-03 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 124 MALLARD ST GREENVILLE, SC 29601-4046 United States Phone: 864-241-1040 | Fax: | ||||||||
| Primary Practice Address | 124 MALLARD ST GREENVILLE, SC 29601-4046 United States Phone: 864-241-1040 | Fax: | ||||||||
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