| NPI | 1760609853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOU JESSUP Insurance Processor 864-963-9090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 19077) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |