MS. Marisa Elizabeth Tetreault
NPI #1063904191 in Columbia, South Carolina
Provider Information
- NPI Number
- 1063904191
- Entity Type
- Individual
- Name
- MS. Marisa Elizabeth Tetreault
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Technician, Other
- Enumeration Date
- Jun 4, 2018
- Last Updated
- Jun 4, 2018
Practice Location
- Address
- 612 DEVINE ST UNIT 434
- City
- Columbia
- State
- South Carolina
- ZIP Code
- 29201-5276
- Phone
- (704) 473-5172
Specialties & Taxonomy Codes
| Specialty |
|---|
| Technician, Other |
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