| NPI | 1124176896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN J. BRODERICK-CANTWELL Sole Proprietor 843-971-9495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 28903) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-08-22 |