| NPI | 1417702481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHENAIL NICOLE MULDROW Director 843-617-6726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2024-04-22 |
| Last Update Date | 2024-05-01 |