| NPI | 1538680004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI LAWRENCE Director Provider Enrollment 864-385-4790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 207XS0106X Orthopaedic Surgery Hand Surgery | |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery | |
| 207XX0005X Orthopaedic Surgery Sports Medicine | |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2023-01-30 |