| NPI | 1093814055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WILLIAM THURMOND President 803-279-1412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC SC8076) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 12890) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2007-12-14 |