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Antonio Lamar Rivers, Hair Loss Specialis

Specialist, Prosthetics Case Management in North Charleston, SC. Individual provider (NPI-1).

NPI number1164033742
StatusActive
Last updated in NPPESAug 16, 2020

Details

NPI
1164033742
Entity type
Individual (NPI-1)
Name
Mr. Antonio Lamar Rivers
Credential
Hair Loss Specialis
Sex
Male
Sole proprietor
No
Enumeration date
Aug 16, 2020
Certification date
Aug 16, 2020
Last updated
Aug 16, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1744P3200X Specialist, Prosthetics Case Management2677SCYes

Practice location

2702 W Surrey Dr
North Charleston, SC 29405-5513

Phone 843-224-3574

Mailing address

2702 W Surrey Dr
North Charleston, SC 29405-5513

Phone 843-224-3574

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