Individual
PEYTON LARUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
920 DOUG WHITE DR STE 210, MYRTLE BEACH, SC 29572-4181
(843) 497-6348
(843) 497-6351
Mailing address
920 DOUG WHITE DR STE 210, MYRTLE BEACH, SC 29572-4181
(843) 497-6348
(843) 497-6351
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4104
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/31/2019
Last updated
11/22/2021
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