| NPI | 1780164541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA W SUVAL President 864-616-3675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: SC 26874) |
| Enumeration Date | 2018-08-20 |
| Last Update Date | 2018-08-20 |