| NPI | 1740390715 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JAMES GARRICK WILSON Owner 803-206-2110  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local | 
| Enumeration Date | 2006-08-30 | 
| Last Update Date | 2020-08-22 |