Individual
MRS. BRITTANY LONG LOVELACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA - C
Contact information
Practice address
600 N WHEELER AVE, PROSPERITY, SC 29127-9332
(803) 364-4852
Mailing address
PO BOX 630, PROSPERITY, SC 29127-0630
(803) 364-4852
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA1709
SC
363AS0400X
Surgical Physician Assistant
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Other
Enumeration date
10/20/2011
Last updated
02/23/2017
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