| NPI | 1609484625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM PETRUS VP Of Finance 843-410-6691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2021-04-21 |