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 |