| NPI | 1467031419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELA S CLARIDA Operations Manager 843-222-5395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2021-07-30 |