| NPI | 1740042563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABBY ROBB RUSSELL Director Of Implementations 864-900-5687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2024-01-26 |
| Last Update Date | 2024-01-26 |