| NPI | 1700233541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNESHIA GRAHAM Medical Office Administrator 843-771-0220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 293D00000X Physiological Laboratory (Licence: SC 20048054) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2016-05-23 |