| NPI | 1619479342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE THOMAS Practice Administrator 864-399-9070 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 261QP1100X Clinic/Center Podiatric |
| Enumeration Date | 2018-03-08 |
| Last Update Date | 2020-04-08 |