| NPI | 1578516001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN BRUCE Credentialing Specialist 864-560-4057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2020-08-22 |