| NPI | 1366292096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA GLASER CEO 843-212-6788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2024-03-25 |
| Last Update Date | 2024-03-25 |