| NPI | 1720175573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM L HIEBERT CEO 803-779-3070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: SC 040627740) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-08-22 |