Christian Lara-Ensslin, PA-C

NPI #1124766134 in Loris, South Carolina

Provider Information

NPI Number: 1124766134
Entity Type: Individual
Name: Christian Lara-Ensslin, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: May 20, 2022
Last Updated: Aug 6, 2023

Practice Location

Address: 3655 MITCHELL ST
City: Loris
State: South Carolina
ZIP Code: 29569-2827
Phone: (843) 716-7000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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