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Individual

LOMETRIA WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
108A E MAIN ST, LATTA, SC 29565-1617
(843) 616-8770
Mailing address
611 SANDORRA RD, LATTA, SC 29565-5323
(843) 616-8770
(843) 433-8132

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
291U00000X
Clinical Medical Laboratory
42D2257730
SC
291U00000X
Clinical Medical Laboratory
332U00000X
Home Delivered Meals
374U00000X
Home Health Aide
376J00000X
Homemaker
376K00000X
Nurse's Aide
Primary
SC

Other

Enumeration date
02/02/2022
Last updated
04/12/2022
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