NPI | 1134277882 |
---|---|
Entity Type | Organization |
Authorized Contact | MARY M VARN Owner 864-587-9872 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: SC 16260) |
Enumeration Date | 2007-01-08 |
Last Update Date | 2012-02-21 |