NPI | 1376505990 |
---|---|
Entity Type | Organization |
Authorized Contact | JENNIFER MARY PATRONIK Office Manager 803-329-1660 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: SC 14896) |
Additional Taxonomies | 174400000X Specialist (Licence: SC 17962) |
174400000X Specialist (Licence: NC 39768) | |
174400000X Specialist (Licence: NC 01456) | |
Enumeration Date | 2006-04-06 |
Last Update Date | 2009-02-17 |