| NPI | 1598227431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES PROCTOR Medical Director/Owner 843-488-7730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2020-03-11 |