| NPI | 1487830964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA W THOMPSON Administrator 803-926-8780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: SC MD7394) |
| Additional Taxonomies | 261QS1200X Clinic/Center, Sleep Disorder Diagnostic (Licence: AL MD5034) |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2008-04-15 |