| 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 |