| NPI | 1598379729 |
|---|---|
| Former Legal Business Name | NEW RIVER AUTO MALL DBA WELLNESS CTR |
| Entity Type | Organization |
| Authorized Contact | CRAIG WEYER Owner/CEO 843-547-4058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2020-09-04 |
| Last Update Date | 2020-09-04 |