| NPI | 1588615488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS F MACMILLAN Owner 864-833-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: SC 0991) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2008-08-05 |