| NPI | 1457324907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAREY MOLIN GULLY Owner/Physician 864-888-4464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: SC 246601) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: SC 101794) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2011-01-25 |