| NPI | 1255039707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUMMER WATTS Fnp 843-340-2672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-02-22 |
| Last Update Date | 2024-12-18 |