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1487636643
LISA D GANTT
GREENVILLE, SC
NPI
1487636643
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: SC A764)
Enumeration Date
2005-11-15
Last Update Date
2014-01-31
Business Address
-- LISA D GANTT ANP
200 PATEWOOD DR STE B200
GREENVILLE, SC 29615-6321
Phone number: 864-232-7338
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Mailing Address
-- LISA D GANTT ANP
PO BOX 8676
GREENVILLE, SC 29604-8676
Phone number: 864-232-7338
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