| NPI | 1043846595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA NICHOLS Chief Operating Officer 843-705-1515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2022-06-15 |