| NPI | 1295918191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE DAVIS Insurance/Billing 803-535-3507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: SC 17228) |
| Enumeration Date | 2007-12-13 |
| Last Update Date | 2007-12-13 |