NPI | 1417602509 |
---|---|
Entity Type | Organization |
Authorized Contact | SANDRA DOYLE Practice Manager 843-486-0999 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 363L00000X Nurse Practitioner |
111N00000X Chiropractor | |
225100000X Physical Therapist | |
332B00000X Durable Medical Equipment & Medical Supplies | |
Enumeration Date | 2022-02-16 |
Last Update Date | 2022-03-03 |