| NPI | 1184737892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH A MANN Office Manager 803-635-6461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2022-08-23 |