| NPI | 1447724588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN CHURCH Clinic Coordinator 843-422-8070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Enumeration Date | 2019-01-11 |
| Last Update Date | 2019-01-11 |