| NPI | 1588445324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY MILLER Authorized Official/Owner 864-680-8376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2023-10-09 |
| Last Update Date | 2024-04-11 |