Individual
SAMANTHA LAKE HOLLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
764 SACO LOWELL RD, EASLEY, SC 29640-3880
(864) 855-5525
Mailing address
764 SACO LOWELL RD, EASLEY, SC 29640-3880
(864) 855-5525
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
83048
SC
Other
Enumeration date
06/16/2016
Last updated
02/23/2023
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