| NPI | 1780825539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUONG T NGUYEN Office Manager 803-526-6069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: NC 001000864) |
| 261QH0100X Clinic/Center, Health Services (Licence: NC 34951) | |
| Enumeration Date | 2009-03-08 |
| Last Update Date | 2016-01-19 |