| NPI | 1164090957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERLISHA GOINS Provider 803-594-3300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2021-09-14 |