| NPI | 1629234141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNE NICOLA GEURKINK Owner/Provider 803-732-0920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: SC 19500) |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2008-08-04 |