LARISA DIFFLEY

CHARLESTON, SC
NPI1023401890
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: SC  2200)
Enumeration Date2015-03-18
Last Update Date2015-03-18
Business Address
-- LARISA DIFFLEY
171 ASHLEY AVE
CHARLESTON, SC 29425-8908
Phone number: 843-792-1414
Mailing Address
-- LARISA DIFFLEY
PO BOX 751461
CHARLOTTE, NC 28275-1461
Phone number: 843-792-6200
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