| NPI | 1295906816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DAVID BOHLER Owner 843-556-1285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: SC 21101) |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2011-02-24 |