Organization
LORIS SURGICAL ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LANE INGRAM MOORE MD (PRESIDENT)
(843) 756-5524
Entity
Organization
Contact information
Practice address
3327 CASEY ST, LORIS, SC 29569-2811
(843) 756-5524
Mailing address
3327 CASEY ST, P.O. BOX 798, LORIS, SC 29569-2811
(843) 756-5524
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
02/08/2007
Last updated
08/22/2020
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