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 |