| NPI | 1699123026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS C ROUSE Owner / Member 843-758-0675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 207Q00000X Family Medicine | |
| 225700000X Massage Therapist | |
| 235500000X Specialist/Technologist | |
| 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2024-08-01 |