NPI | 1528362621 |
---|---|
Entity Type | Organization |
Authorized Contact | STEPHEN J KROLL Doctor/Medical Director 803-345-0334 |
Organization Subpart ? | No |
Primary Taxonomy | 171W00000X Contractor (Licence: SC 7485) |
Enumeration Date | 2011-01-04 |
Last Update Date | 2011-03-10 |