| NPI | 1316533474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIEVERS CUNNINGHAM Medical Director 803-254-8449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2020-12-14 |
| Last Update Date | 2020-12-14 |