COASTAL PODIATRY, LLC
Podiatry at Wingo Way, Mount Pleasant, SC

License number
South Carolina 607
Category
Podiatry
Type
Podiatrist
Owner
Name: DR. TAMIKA MICHELLE BOLDEN RAVENELL DPM
Title: OWNER
Phone: (916) 215-1234
Address
Address
180 Wingo Way SUITE 201, Mount Pleasant, SC 29464
National Provider ID: 1659648152
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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COASTAL PODIATRY, LLC

Mount Pleasant, SC

Status:
Inactive
Industry:
Podiatrist's Office
Registration:
Jan 1, 2011
Addresses:
180 Wingo Way, Mount Pleasant, SC 29464 (Physical)
1504 Belle Pt Dr, Mount Pleasant, SC 29464
Business type:
Domestic
Formation place:
SOUTH CAROLINA
Partners:
Tamika Michelle Bolden Ravenell (Podiatrist),Tamika Bolden Owner, Podiatrist, Principal, inactive,Rahn A. Ravenell Partner, inactive

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