| NPI | 1245301985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK D WISE President 864-847-6020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 20856) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: SC 1743) |
| 111N00000X Chiropractor (Licence: SC 1594) | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2019-08-21 |