| NPI | 1669864948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL RAYMOND MITCHELL Owner/Physician 843-415-8511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: SC 00666) |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2015-04-03 |