| NPI | 1063837870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON PERCIVAL President 803-285-1411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: SC 531) |
| Enumeration Date | 2014-03-03 |
| Last Update Date | 2014-03-03 |