| NPI | 1609058254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANKLIN CARN COULTER Provider 803-534-0438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: SC 10582) |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2010-06-25 |