| NPI | 1528643608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATOYA SIERRA LANE-MILO Nurse Practitioner 843-506-9836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2021-03-10 |
| Last Update Date | 2024-08-13 |