| NPI | 1467848796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY M THAMES Owner/ Clinical Director 803-984-0335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: SC 150312-0036) |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2015-04-14 |