| NPI | 1568662708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA A. SNOW Part Ownership 843-206-3997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0006X Clinic/Center, Ambulatory Fertility Facility (Licence: SC 021312287) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: SC 021312287) |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2007-07-24 |