| NPI | 1770809428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD B GUNNLAUGSSON Owner 803-509-7200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: SC 28760) |
| Additional Taxonomies | 207YS0012X Otolaryngology Sleep Medicine (Licence: SC 28760) |
| 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: SC 28760) | |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2023-03-07 |