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1356194351
LUKE RICHARD LISH
CONWAY, SC
NPI
1356194351
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: SC 1356194351)
Enumeration Date
2024-04-09
Last Update Date
2024-07-25
Business Address
LUKE RICHARD LISH MD
300 SINGLETON RIDGE RD
CONWAY, SC 29526-9142
Phone number: 843-347-7111
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Mailing Address
LUKE RICHARD LISH MD
2602 BLUE CRANE CIR UNIT 104
MYRTLE BEACH, SC 29577-2198
Phone number:
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