| NPI | 1578650792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES LELAND ANDERSON Owner 864-295-1750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: SC 7401) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2007-10-10 |