| NPI | 1285288225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRYSTAL M COATES-GAL President/Owner 843-945-8117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2021-06-15 |