| NPI | 1245651819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTY RAE ANDERSON Billing Department 803-359-7527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: SC 24782) |
| Enumeration Date | 2013-12-26 |
| Last Update Date | 2013-12-26 |