| NPI | 1639428527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIA THOMAS Owner 843-712-1897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: SC SC32133) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2012-09-06 |