| NPI | 1194857342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRENTON K STATLER Physician/Partner 843-524-0232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 007222542) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2023-08-16 |