Individual
LORI DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
220 MCGEE RD, ANDERSON, SC 29625-2104
(864) 260-5633
Mailing address
120 HIAWATHA DR, BELTON, SC 29627-2108
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27615P
SC
Other
Enumeration date
04/11/2014
Last updated
04/11/2014
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