| NPI | 1386940872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE MICHAEL WEST Owner 843-413-0303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: SC 000664) |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2011-02-01 |