| NPI | 1669409009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM D GLENN Owner 803-245-5144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: SC 261QR1300X) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2008-04-28 |