| NPI | 1518238203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL G WENNER Owner 843-662-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2012-01-26 |
| Last Update Date | 2021-08-10 |