| NPI | 1366564007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON DAVID CANSLER President 803-649-0599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center Rehabilitation (Licence: SC 4606) |
| Additional Taxonomies | 261QR0400X Clinic/Center Rehabilitation (Licence: SC 4637) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-08-22 |