| NPI | 1053740852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFTON W WICKISER President/Owner 864-224-0246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC MD14473) |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2024-05-22 |