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 |