| NPI | 1720135254 |
|---|---|
| Former Legal Business Name | LORIS SURGICAL ASSOCIATES, P.A. |
| Entity Type | Organization |
| Authorized Contact | LANE INGRAM MOORE Manager 843-756-5524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2020-08-22 |