NPI | 1770936411 |
---|---|
Doing Business As | EAGERTON FAMILY PRACTICE |
Entity Type | Organization |
Authorized Contact | DANE P FICCO Senior Vice President 843-777-7010 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2016-07-18 |
Last Update Date | 2016-07-18 |