| NPI | 1609270743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONI MANOS M.D. 843-302-0920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: SC 1801218196) |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2014-10-17 |