Individual
LACEY WILBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
108 MONTGOMERY DR, ANDERSON, SC 29621-3334
(864) 225-5597
Mailing address
108 MONTGOMERY DR, ANDERSON, SC 29621-3334
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
27810
SC
Other
Enumeration date
08/29/2023
Last updated
08/29/2023
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