Healthcare Provider Details

I. General information

NPI: 1215485685
Provider Name (Legal Business Name): LAURA TIMMONS STRICKLAND PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2016
Last Update Date: 03/03/2021
Certification Date: 03/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E CHEVES ST STE 480-B
FLORENCE SC
29506-2650
US

IV. Provider business mailing address

PO BOX 3239
FLORENCE SC
29502-3239
US

V. Phone/Fax

Practice location:
  • Phone: 843-432-1880
  • Fax: 843-432-1022
Mailing address:
  • Phone: 843-777-7092
  • Fax: 843-777-7102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number1137696
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: