| NPI | 1174961882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE CONNER President 803-359-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 111N00000X Chiropractor |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2013-06-05 |