| NPI | 1598313827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE KNIGHT DISHER Credentialing Specialist 803-773-5227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2019-08-29 |