| NPI | 1649647884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA M JEFFCOAT Vice President & Secretary 803-957-0500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2021-03-15 |