| NPI | 1538527254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE SCHWAB Medical Director 803-309-0685 |
| Organization Subpart ? | |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: SC MD18512) |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2016-02-09 |