| NPI | 1023155728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY OWENS Operations Manager 803-699-9073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2025-07-21 |