| NPI | 1053622050 |
|---|---|
| Doing Business As | WAVERLY FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | DELGADO CANTAVE CEO 803-733-5969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2022-02-03 |