| NPI | 1306378773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY JOHNSON TEAL Family Nurse Practitioner 843-921-2620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251J00000X Nursing Care (Licence: SC 20722) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2017-04-03 |