| NPI | 1083038780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT F. GARRISON Owner 803-661-8468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: SC 302494) |
| Enumeration Date | 2014-02-17 |
| Last Update Date | 2014-02-17 |