Individual
LISA FOUTZ GANTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
200 MCDANIEL AVE, PICKENS, SC 29671-2527
(864) 898-5965
Mailing address
200 MCDANIEL AVENUE, PICKENS, SC 29671
(864) 898-5965
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P44091
SC
Other
Enumeration date
09/20/2017
Last updated
07/21/2022
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