| NPI | 1225050271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA J EKMAN President 803-376-8880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: SC 3168) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2008-01-30 |