Individual
ANDRE LOTRICK BLIZZARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1600 GATEWAY RD, FLORENCE, SC 29501-8123
(470) 885-3990
Mailing address
1600 GATEWAY RD, FLORENCE, SC 29501-8123
(470) 885-3990
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002061531
VA
Other
Enumeration date
07/01/2025
Last updated
07/01/2025
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