| NPI | 1023853504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA LYNN REED Owner 843-822-7404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2024-06-27 |
| Last Update Date | 2024-06-27 |