| NPI | 1003070103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH R WEST Owner 843-761-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2010-06-09 |