| NPI | 1700133923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM BEN CLARK President/Owner 803-259-1909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: SC AC8016289) |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2012-08-07 |