| NPI | 1760633960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHA MATTHEWS BOONE President 803-358-9843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: SC 24923) |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2008-10-06 |