Healthcare Provider Details

I. General information

NPI: 1952049546
Provider Name (Legal Business Name): BRIANNA CATHERINE LACH DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2022
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 SE MAIN ST
SIMPSONVILLE SC
29681-7150
US

IV. Provider business mailing address

801 SE MAIN ST
SIMPSONVILLE SC
29681-7150
US

V. Phone/Fax

Practice location:
  • Phone: 864-399-9070
  • Fax:
Mailing address:
  • Phone: 864-399-9070
  • Fax: 864-399-9664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number789
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: