Individual
LILLIAN BRANDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
180 WINGO WAY, SUITE 301, MT PLEASANT, SC 29464-1810
(843) 518-1988
Mailing address
1217 HILLSIDE DR, HANAHAN, SC 29410-2013
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1587
SC
Other
Enumeration date
04/08/2016
Last updated
04/08/2016
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