| NPI | 1760829519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GASTON MACHADO Medical Director 843-572-5990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: SC 13512) |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2013-06-03 |