Provider Demographics
NPI:1992234033
Name:STRICKLAND, KELLY WORKMAN
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:WORKMAN
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 EAGLE POINTE DR
Mailing Address - Street 2:
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29036-9248
Mailing Address - Country:US
Mailing Address - Phone:803-470-2958
Mailing Address - Fax:
Practice Address - Street 1:164 EAGLE POINTE DR
Practice Address - Street 2:
Practice Address - City:CHAPIN
Practice Address - State:SC
Practice Address - Zip Code:29036-9248
Practice Address - Country:US
Practice Address - Phone:803-470-2958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies