| NPI | 1356786750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALENCIA GISELLE GRAY-WILLIAMS Director 803-360-7896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2022-02-15 |