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