| NPI | 1770560526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE E RICHARDS Office Manager 803-366-9119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 77686) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2020-08-22 |