IndividualActive
Marisa Tetreault
NPI 1063904191 · Other Technician · Columbia, SC
Provider details
- NPI number
- 1063904191
- Entity type
- Individual
- Primary specialty
- Other TechnicianTechnologists, Technicians & Other Technical Service Providers
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Technologists, Technicians & Other Technical Service Providers
Practice location
612 Devine St Unit 434
Columbia, SC 29201-5276
Phone: (704) 473-5172
Approximate (ZIP-level) locationGet directions
Mailing address
612 Devine St Unit 434
Columbia, SC 29201-5276
Registry dates
- Enumerated
- 2018-06-04
- Last updated
- 2018-06-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.