| NPI | 1639108582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS CORNELIUS MCFADDEN Medical Director 864-297-9113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: SC 2236) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2020-08-22 |