| NPI | 1205625985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HILLERY DOLFORD Owner 843-992-2754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| Enumeration Date | 2025-05-01 |
| Last Update Date | 2025-05-01 |