| NPI | 1588622120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA MARIE LAPRISE Billing Supervisor/Representative 803-405-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2020-08-22 |