NPI | 1205113248 |
---|---|
Doing Business As | MCLEOD LORIS PRIMARY CARE |
Entity Type | Organization |
Authorized Contact | KENNETH D. BEASLEY Senior Vice President 843-777-7010 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
Enumeration Date | 2011-11-04 |
Last Update Date | 2022-06-07 |