| NPI | 1235336082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAORU JOAN PRIDGEN Md 803-462-2335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: SC 25856) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2008-08-29 |