| NPI | 1700179504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANKLIN COULTER Owner 803-534-0437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: SC 10582) |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2011-05-26 |