| NPI | 1447383666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES GUY CASTLES President 803-799-9044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: SC PC074) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |