NPI | 1265440705 |
---|---|
Doing Business As | N/A |
Entity Type | Organization |
Authorized Contact | YOHANNES NEGASH President 803-256-6828 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Enumeration Date | 2006-08-03 |
Last Update Date | 2020-08-22 |