| NPI | 1285096388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAJA PALADUGU President 864-254-9330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: SC 19254) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2016-03-28 |