| NPI | 1619972791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE PANKEY Administrator 864-560-5821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: SC ASF-064) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2007-12-19 |