| NPI | 1326237538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS ROY ANDERSON President 803-732-2554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: SC 9529) |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2017-01-26 |