| NPI | 1477947927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD LLOYD BOWEN Owner 843-480-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: SC 13239) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2015-03-23 |