| NPI | 1669714606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACIE MIXON WOODWARD Owner 843-437-5456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: SC 18982) |
| 364SF0001X Clinical Nurse Specialist, Family Health (Licence: TN 17346) | |
| Enumeration Date | 2013-03-16 |
| Last Update Date | 2018-04-27 |