Individual
CHRISTINE NOEL LYLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
631 JOHNNIE DODDS BLVD, MOUNT PLEASANT, SC 29464-3030
(843) 881-0815
(843) 881-0743
Mailing address
PO BOX 749306, ATLANTA, GA 30374-9306
(843) 881-0815
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4696
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6175PA
—
SC
Enumeration date
01/16/2020
Last updated
11/03/2024
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