74 POLO ROAD, LLC

COLUMBIA, SC
NPI1093262628
Entity TypeOrganization
Authorized ContactJEFF LEHRICH
Executive Director
480-235-7788
Organization Subpart ?Yes
Primary Taxonomy261QM1300X Clinic/Center, Multi-Specialty
(Licence: SC  20381)
Enumeration Date2016-09-01
Last Update Date2016-09-01