| NPI | 1093812224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET NICKERSON Office Manager 803-276-4860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 14534) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2012-11-28 |