| NPI | 1114116019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA REGINA LEGGETT Office Manager 843-679-6881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: SC 27687) |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2007-10-17 |