| NPI | 1629367693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES C PULLIAM Manager 803-758-5962 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225500000X Specialist/Technologist (Licence: SC 0724727) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: SC 0724727) |
| 225600000X Dance Therapist (Licence: SC 0724727) | |
| 225700000X Massage Therapist (Licence: SC 0724727) | |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2011-03-30 |