| NPI | 1104259340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN BRANHAM TOMARCHIO Medical Director 803-896-1233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: SC 33514) |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2013-08-12 |