LARA WINE LEE

CHARLESTON, SC
NPI1710187224
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207NP0225X Dermatology, Pediatric Dermatology
(Licence: SC  37328)
Additional Taxonomies208000000X Pediatrics
(Licence: PA  MT190407)
207N00000X Dermatology
(Licence: SC  37328)
Enumeration Date2007-07-23
Last Update Date2020-10-22
Business Address
LARA WINE LEE M.D.
171 ASHLEY AVE
CHARLESTON, SC 29425-8908
Phone number: 843-792-1414
Mailing Address
LARA WINE LEE M.D.
PO BOX 751461
CHARLOTTE, NC 28275-1461
Phone number: 843-792-6200