| NPI | 1710158985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY W DURANT Owner 843-437-9083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2015-01-28 |