Individual
MRS. LISA JETT MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3021 REIDVILLE RD, SPARTANBURG, SC 29301-5643
(864) 576-9201
(864) 576-6584
Mailing address
3021 REIDVILLE ROAD, SPARTANBURG, SC 29301
(864) 576-9201
(864) 576-6584
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19722
SC
Other
Enumeration date
10/27/2015
Last updated
10/27/2015
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