| NPI | 1760674261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE M MASSIE Practice Manager 803-325-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC SC28333) |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: SC 1323) |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2007-08-17 |