| NPI | 1376998096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAYNARD ASHLEY HUTSON Owner/Manager 864-884-1137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology (Licence: GA 75523) |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2016-05-02 |