Individual
LAUREN LOOPER GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
315 MEDICAL PKWY STE 100, GREER, SC 29650
(864) 454-7422
(864) 797-9701
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3355
SC
363A00000X
Physician Assistant
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3985PA
—
SC
Enumeration date
10/03/2017
Last updated
04/27/2023
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