| NPI | 1730138157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN J PHILLIPS Medical Director 843-215-3363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: SC 26821) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2011-09-26 |