NPI | 1437648904 |
---|---|
Entity Type | Organization |
Authorized Contact | GRANT LEE CLUXTON CEO 864-442-4110 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 18996) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 18997) |
Enumeration Date | 2018-05-09 |
Last Update Date | 2021-03-02 |