| NPI | 1720526981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN KIMBERLY SOOTER Credentialing Coordinator 803-256-4107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2023-01-19 |