| NPI | 1376091645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA ELLEN MAGERA Owner 843-762-9321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: SC 14542) |
| Enumeration Date | 2016-09-15 |
| Last Update Date | 2016-09-15 |