| NPI | 1598835639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRAINE VERONICA TYLER Practice Administr AO T 843-797-8880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: SC G93021) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-08-22 |