| NPI | 1356672927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HORACE WILLIAM BLEDSOE Owner 803-359-0164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: SC 8883) |
| Enumeration Date | 2010-01-21 |
| Last Update Date | 2018-10-15 |