| NPI | 1730667247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMIEKA LATRELL ALSTON-GIBSON Owner/Operator 864-358-9278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 19703) |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2023-03-27 |