| NPI | 1790852994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN J PLY Medical Director 843-651-8211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: SC ASF-085) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2020-08-22 |