Individual
LORELA PENGU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
210 VILLAGE CENTER BLVD STE 200, MYRTLE BEACH, SC 29579-6706
(843) 353-3460
(843) 353-3461
Mailing address
210 VILLAGE CENTER BLVD STE 140, MYRTLE BEACH, SC 29579-6706
(843) 353-3460
(843) 353-3461
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5738
SC
Other
Enumeration date
02/04/2025
Last updated
03/24/2025
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