| NPI | 1689757551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH CARTER President 803-758-2997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: SC 0689889) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2007-09-05 |