| NPI | 1528274669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WATSON MARTIN Owner President 864-225-5436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 719) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SC 4618) |
| 208D00000X General Practice (Licence: SC 5222) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-08-22 |