NPI | 1598119885 |
---|---|
Entity Type | Organization |
Authorized Contact | GLENN L SCOTT Owner 864-582-3456 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: SC 6850) |
Enumeration Date | 2016-04-22 |
Last Update Date | 2016-05-03 |