| NPI | 1669950903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURENCE STEVEN BLUMENTHAL Medical Director 843-792-3664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2018-07-30 |