| NPI | 1164481933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE R. THOMPSON Physician 803-788-8883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: SC 22066) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2020-08-22 |