| NPI | 1427792886 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | TAMMY ELIZABETH HIOTT Nurse Practitioner 843-574-7840  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care | 
| Enumeration Date | 2022-04-22 | 
| Last Update Date | 2023-03-07 |