| NPI | 1225055288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM SMITH Administrator 843-692-2167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 261QR0200X Clinic/Center Radiology |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2008-04-20 |