| NPI | 1316369556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATIENCE MANTE Administrator 803-313-3846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: SC 29696) |
| Enumeration Date | 2014-01-07 |
| Last Update Date | 2014-01-07 |