| NPI | 1376873802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY R. LUTZ Office Manager 843-549-6331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: SC SC217768) |
| Enumeration Date | 2010-01-06 |
| Last Update Date | 2010-01-06 |