| NPI | 1750124145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENYFER FOUST Director 803-489-8777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QU0200X Clinic/Center, Urgent Care | |
| 261QV0200X Clinic/Center, VA | |
| 364SF0001X Clinical Nurse Specialist, Family Health | |
| Enumeration Date | 2024-06-14 |
| Last Update Date | 2024-09-11 |