Healthcare Provider Details

I. General information

NPI: 1710852470
Provider Name (Legal Business Name): LORALYN EDWARDS L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2025
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2821 ASHLAND RD BUILDING-A, SUITE #40
COLUMBIA SC
29210
US

IV. Provider business mailing address

2821 ASHLAND RD BUILDING-A, SUITE #40
COLUMBIA SC
29210
US

V. Phone/Fax

Practice location:
  • Phone: 803-528-8844
  • Fax:
Mailing address:
  • Phone: 803-528-8844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberACU-112
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: