| NPI | 1053191320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATOYA SIERRA LANE-MILO Owner 843-407-4451 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2023-10-03 |
| Last Update Date | 2023-10-03 |